Recognizing a Cry for Help
It can be easy in the teen years not to pick up on the first hints of trouble with your child. There's so much going on anyway: new independence, fewer restrictions, tougher classes, and even new friends. But parents and caregivers need to keep a close watch on their teens to help steer them away from trouble in “diabetes land.”
Fantasy Versus Reality
Your child, and you, may end up with two distinctly different frames of reference: fantasy and reality. In fantasy, your child is completely compliant with their diabetes care. He doesn't mind blood checks; he is careful when he is out with friends. Your child tells you he's fine on his own and that he is now ready to take on diabetes by himself. The teen years are absolutely not the time for this. (See Chapter 15 for a detailed discussion on independence and timing.)
This is tough because as a parent, your instinct tells you to encourage your teen to work on his own; he is growing up and spreading his wings. But most pediatric endocrinologists agree that teens need direct parental involvement in diabetes care up until the time they go to college and sometimes longer than that.
For your child, the fantasy may be that he doesn't really have diabetes; or it really does not require the care that you insist it does.
In some cases, sadly, this can all come to a head in the emergency room. More than one parent has found out for the first time that their teen has been noncompliant after they develop diabetic ketoacidosis, a life-threatening condition described in Chapter 5. Others are lucky enough to find out by an elevated A1c. If you do discover this way, keep in mind: In your teen's fantasy world, this may be the first time he actually realizes he's been off the program.
Weight Loss and a Bad Self-Image
Teens, too, can suffer from eating disorders and depression. If you notice your teen is running high blood sugars, you may want to explore the possibility of an eating disorder.
Question?
My child eats a lot. How can she have a disorder?
Diabulimia is the act of eating and then not bolusing for it, which allows the person to eat all he or she wants and still lose weight because of the lack of insulin. This is a dangerous situation.
As for depression, teens who have a sudden drop in grades, a sudden change in social activity, or moodiness beyond what you consider normal teen angst should talk to their social worker.
If you luck out, you may never have to deal with any of this. If you do, know that most teens with diabetes struggle. You are far from alone.
