The preteen and teen years are a rocky time for all kids. As their social identities emerge, they start such eternally awkward rituals as dating, and they pull away from their parents to find their own sense of self and establish their independence. This is a particularly tricky time for adolescents with diabetes, who may be desperately trying to find a way to “fit in” when their blood glucose checks, insulin pump, and eating habits all say, “I'm different.”

The hormonal changes of puberty also take a toll on diabetes control in and of themselves, increasing overall insulin resistance. Girls and boys face a sea change in their bodies that makes control a bit more elusive than normal. Things will stabilize after a time.

This is also an age for experimentation with drugs, alcohol, and smoking, all things that will affect your child's blood glucose control in ways he is not accustomed to. Worse, drugs and alcohol can affect your child's perception of blood glucose lows and impair his ability to make good decisions. Now is the time to have a frank talk about drugs, alcohol, and cigarettes. Your child needs to know how it will affect his diabetes, and what precautions he needs to take if he does try any of these things.

Giving him this information is not the same as saying you approve of his experimentation with drugs or alcohol; in fact, he also needs to know explicitly that you don't want him using at all. But since adolescence is often filled with bad decisions as teens try to find their own identity, educating your child for the possibility could literally save his life.