Teens with diabetes: How do you get through to them!?
Being so open about having diabetes means I’ve pretty much been asked all there is to be asked about this disease. And there are several questions that fall into the “recurring theme” bucket (“Are you allowed to eat that?” does NOT count. Because it’s not a good question.). One of my top five questions for sure though, is parents of teenagers asking how the heck they can get their kid to take care of their diabetes. “You were once a teen with diabetes,” they start off. “How the heck did your parents get you to take care of this disease, because my kid won’t listen to anything I say!”
And here’s the tough part about that question: I was that kid. I was the teenager who didn’t check her blood sugar and skipped shots. And I was subsequently the teenager who ended up in the hospital with DKA, miserably strapped to two IVs, far away from all the “cool things I was missing out on” at my high school.
For me, it was that bout of DKA that scared me straight. Once I landed in that hospital, I knew I never EVER wanted to be there again. It was that awful experience that taught me there was nothing cool about being sick and in the ER, and that if I took care of my diabetes, I could get right back to all that stuff my 18-year-old brain thought was sooooo important (and by the way, none of it was important, but you can’t tell that to a high-school senior).
But my DKA happened at 18, and at that point I’d had bad habits and terrible A1cs for years. I might eventually pay the price for those years of poor control – despite my best efforts today. And I hear from many parents that DKA doesn’t scare their kids – the hospital stay is just a sideline to their uber-cool lives, and as soon as they get out they’re right back to ignoring their diabetes. Teenagers already think they’re invincible, and they also think anything that makes them different isn’t cool. Combine that with diabetes which A) makes you different and B) kicks even invincible ass and you’ve got a recipe for disaster. It’s no wonder parents ask me that question all the time – they want their kids around for as long as they are, and they’re scared s*&tless that their child is going to wind up in the hospital – or worse. In fact, diabetes the fastest way to turn even the coolest parent into an obnoxious nag, prime for having a door slammed in their face the next time they want to talk about “the diabetes.” Exhausted yet? Me too, and I don’t even have kids yet.
So what advice does the girl who was just as bad as the rest have to give to parents dealing with this now? First of all, don’t sugarcoat it (every pun intended): this isn’t going to be easy. The teenage years are, psychologically speaking, the prime time of developing independent thoughts and actions, which are essential skills for being a successful adult. And although that usually presents itself in the form of talking back and sulking, it is an important time for their personal growth. Parents of teens with diabetes should encourage independence, but also be truthful. It’s ok to agree with your teen that diabetes is a total pain in the ass, but the focus then needs to shift onto the fact that NOT taking care of it will hold you back. You can’t go to prom/get your driver’s license/travel with the debate team if you’re in the hospital sick from diabetes. The better care you take of this disease, the less is holds you back.
Second, parents have to understand that it’s not about getting their teen to see long term. Why? Because think about the last time you asked a teenager what career he or she wanted to pursue. A lucky few might have it nailed down already, but most of them give a vague answer about marketing or waiting tables in Ibiza for a few years and don’t really have a plan. That’s what college and the workforce is for. Teens don’t have it all figured out right now because all that matters is tomorrow’s test and what they’re wearing to winter formal. Long-term planning has never been the hallmark of the teen years, and teens with diabetes won’t be motivated by someone telling them “if you do everything perfectly for the next 30-40 years with this disease, things will probably be ok. We’ll see how it goes in a few decades.”
So if trying to scare your teen with the specters of long-term complications doesn’t prove effective, then what does? I’ve spoken to many doctors, parents, and even diabetes psychologists about this, and there’s no doubt it’s tough to get a teen in great control of their diabetes. But one thing most of them agree on is that there have to be more immediate consequences for teens with diabetes, because long-term scare tactics don’t work. What that means is that teens with diabetes need to have diabetes discipline. Rules and discipline (within reason of course) mean you love your kid. There’s a curfew because you don’t want your child out on the streets at 2am. There are chores because you want to teach your child the value of working for a reward. Guess what? Diabetes is no different. Having diabetes is part of that child’s character the day they are diagnosed, and parents have a responsibility to help them cultivate that character with structure in their lives.
So how do you make rules for diabetic teenager chock full of attitude and zero motivation? Find out what DOES motivate them. I know one mom who made her daughter check her blood sugar every morning. How did she do it? The mom stood on the other side of the kitchen while her daughter tested before school. Her mom didn’t ask to see the number, just watched to make sure she checked. Then, and only then, did her daughter get to go to high school where all her cool friends with their cool outfits and cool boyfriends were. End of story. For that kid, the rules were she had to make her bed, walk the dog, be in by midnight on Saturdays and yes, check her blood sugar before school. It might not seem like much, but think about it – if your teen isn’t testing AT ALL for days on end, one test before breakfast is a heck of a lot better than nothing. And as that teen learns what to do with the numbers and starts to feel better as a result of it, many of them are inclined to keep trying a little more each day. Also, by not looking at the number, it took away the pressure of the mom’s judgment on the teen. The teen knew there would be no scolding or questions. The bottom line is that having rules means we care about how our kids turn out – and that includes their diabetes management. And it’s ok to start small. Remember that testing once a day is better than not testing at all. Get through that hurdle and then worry about the next thing. Diabetes doesn’t need to be – and will never be –perfect.
I can hear the sighs out there: “Yeah right, my kid will never go for that.” I 100% agree with everyone out there who says parenting a teen with diabetes is extremely difficult. But it is not impossible. Looking back on my teen years, I only wish I’d had some rules and guidance to keep me away from that hospital in the first place. Without getting in to the gory details, my childhood wasn’t exactly picture perfect, and I didn’t have a lot of parental support. But I meet so many amazing parents who DO care about their child’s diabetes, and want to do everything they can to help them be successful with this disease. And for all of you parents out there, please know that you are the true heroes. It takes so much strength to parent a kid with diabetes, and just know that even when you think they’ve got you completely tuned out, they are listening, and they want both your guidance and your support. It won’t always be easy, but even the worst ones can really turn out ok. I did!
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Comments
I think I’m one of the few people who would have nailed my diabetes care even in my teens, but if I didn’t, I know my parents would have said, “if you don’t take care of it to this level, you’re not playing in band.” THAT would have got my attention. Usually there is something that teens really enjoy doing which you can dangle like a carrot.
I’d add to the conversation that it is really, really hard (basically impossible) for a teenager with raging hormones/growth spurts to manage their diabetes to the 5-6% A1c level. I don’t think the same standards apply.
My teenage years went through a cycle where I’d do my best, I’d get yelled at and lectured for a 8-9%, say screw it (something teenagers do very well), and get even worse. Nasty cycle.
I’m just saying, cut your kids some slack, remember that nearly everyone’s blood sugars are awful in the teenage years, and we all seen to survive ok.