Teen rebellion and your child’s type 1 diabetes care
For parents of adolescents, any kind of rebellion causes angst. For teens who live with type 1 diabetes (T1D), these years of beginning to feel the power of freedom can have an entirely different taste than they do for teens without diabetes.
Read on to learn more about adolescents rebelling against their diabetes care, including common causes, signs to watch for, how to react as a parent, and what to do next.
This article is from Teen Toolkit, your guide to raising a teenager with type 1 diabetes. Download your free copy here.
About T1D rebellion in teenagers
When it comes to diabetes care, some teens (particularly those who were diagnosed as young kids) begin to move away from being the model patient. Why? Some say it’s burnout; often the trouble comes from burnout from both the teen and their parents. Others say it’s a question of the teen wanting to feel ‘free’ from T1D.
Rebellion in a teen’s T1D care can sneak up on a parent – and it can sneak up on the teen, too. Usually, the first sign of burnout is skipping blood glucose readings. This is often followed by skipping boluses or injections. Teens can also realise that the trust they’ve won from their parents may allow them to perhaps fudge with things a bit.
Ironically, a teen avoiding checking or taking insulin can go to more trouble working around it than just doing the right thing in the first place. They can be very creative – some use a friend’s blood, while others push a bolus through a pump with the pump unattached.
But it’s also important to realise that this could all actually take them by surprise. They’re probably thinking that it’s not a big deal to be a bit dodgy, and that they can turn things around any time. Remember, this is a challenge for the teen as much as it is for the parent. Everyone is learning!
Signs of type 1 diabetes rebellion in teenagers
Often, an elevated HbA1c level can be the first sign that makes parents wonder if their teen is starting to rebel. An elevated HbA1c, however, is not reason to immediately think ‘rebellion!’, since hormones and growth can affect levels.
Here are some signs to watch for:
- Missing blood glucose monitors: Sometimes a teen will ‘lose’ a monitor to avoid the parent finding out about skipped or faked blood sugar checks.
- More frequent and unexplained high blood sugar levels when you witness a reading: Some may be from growth, but there is the possibility of a missed bolus earlier in the day.
- Rapid weight loss, skipping meals, disordered eating, or increased negativity about body image.
How to react if your teen is pushing back against their T1D management
Start by knowing this: your teen is far from alone in rebelling against their T1D. JDRF is flooded with parents asking for help in this exact situation. Your teen isn’t bad or unusual; they’re just trying to find a way through a difficult time with a chronic disease. They need your support and help.
The challenge for you is to react calmly and reasonably. If you find proof of dishonesty, take a deep breath; yelling or punishing them isn’t the solution. You have to find a combination of empathy and responsibility. Apart from that, here are some ideas to try.
Come up with a plan before you even approach your teen about the situation. It’s okay to call your teen’s diabetes educator or endocrinologist ahead of time to discuss how you should proceed. They may suggest an appointment. If they do, take them up on it.
A great way to prompt teens to open up and talk about any subject – not just T1D – is to suggest that they read something on the topic. An honest article about teen struggles may make them more open to discussing things with you.
Use the power of positive suggestion
If you have proof of a false or skipped blood sugar reading or insulin dose, approach it carefully. Instead of accusing them of lying, say something like “I can only imagine how hard it is for you to do this constantly. I noticed it’s been really hard for you to get your blood checks in during school hours. Do you want to talk about figuring out a schedule that works better?” This kind of ‘positive suggesting’ may help them admit something like “I just can’t test before lunch.” If they open up to the idea of a different plan, suggest they meet with their diabetes health professional and come up with a new plan that works better.
Trust their diabetes team
Parents have to be prepared for a teen’s medical team to agree to a plan that involves less checking than they may be used to, but if the diabetes team and your teen come up with a plan that keeps them safe, healthy and willing to engage in care during some tough years, it’s a winner. These years are about slowly moving your teen toward independence; if your child is willing to be responsive in this way, you’re taking a great step.
Focus on the now and avoid long-term scare tactics
Psychological theory tells us that all adolescents find it difficult to think about what their current actions can mean for their future. Saying, “If you run high blood sugar levels now, you might be blind when you’re 40,” may not have any effect on them whatsoever. As teens, who cares about 40? They’re thinking, “But I want to live right now!” Instead, try to put everything in terms of the present. Relate your teen’s blood glucose levels to how they feel, perform in school or sports and what it does to their mood or energy level.
“Help – my child keeps rebelling and their HbA1c level keeps rising!”
So you feel like you’ve tried everything, but your child just isn’t listening? You’re still not alone! More action may be needed, again, keeping the teen’s diabetes team in the loop. Here are some ideas to deal with this.
Ask if they’ve outgrown their diabetes team
Even the most beloved diabetes team may no longer be the perfect fit as your child matures. Ask if they’re happy with their team; if the answer is no, look into making a change and let them be an active participant in the choice. This may be difficult if you attend a public clinic, but it’s worth asking. Remember that young people aged over 16 can transition into the adult system if that helps.
Set boundaries, within reason
For instance, if a driving-age teen is not checking their blood sugar levels, you can’t allow them to drive. It’s dangerous not only to your child, but to everyone else on the road. Teens usually care deeply about driving, so use it to your benefit and take away the privilege if they are not being responsible.
If your teen and their diabetes team comes up with a plan and then they somewhat follow it, reward them with whatever you can. Let them know that you understand that living with T1D isn’t easy. Providing frequent rewards will remind them that you recognise this and that you will always support them.
Find their support
Try to introduce them to other kids in their age group who are experiencing similar T1D challenges and triumphs. Teens don’t like being forced to attend support groups, but there are ways to get them together with a group of peers who are going through the same thing. Type 1 diabetes camps are a safe and effective way of doing this, or attending a T1D social gathering or fundraising event. Alternatively, you might like to investigate online communities and forums – JDRF runs a private Facebook group for people aged 14-25 who live with T1D (and a separate group for their parents).
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