University of Illinois Extension

Growing Up with Diabetes

The impact of diabetes during childhood can be psychological as well as physical. Diabetes and its demands can affect teens' sense of self and security, and can challenge budding independence and decision-making. The physiological changes that occur during adolescence promote insulin resistance, making diabetes control even more difficult. At best, the daily demands of the adolescent make for interesting problems.

Here are specific concerns that typically arise as kids with diabetes grow older.

11-14 Year-Olds

General Characteristics

Impact of Diabetes

How to Approach

Worry about appearances/self-conscious

  • Not wanting others to see fingersticks, injection sites, or medical bracelet
  • Worrying that hypoglycemia will happen around friends or during sports
  • Offer alternatives to traditional ID tags (like shoe tags)
  • Use self-consciousness as a motivator to rotate injection sites
  • Use hypoglycemia as a motivator for proper blood glucose testing

Hormonal changes

  • Having blood glucose fluctuations
  • Increasing insulin resistance
  • Mood changes can mimic hypoglycemia
  • Using pre-loaded insulin pens or pre-mixed insulin to deal with rapidly changing blood glucose levels
  • Modify sick day rules
  • Monitor blood glucose more often

Assert independence from family

  • Skipping insulin shots
  • Ignoring meal plan
  • Not ready for independent self-care
  • Being upset with overprotective parents
  • Use “experiment” approach: teens test out behavior with support and guidance from team
  • Have teen see diabetes team alone
  • Modify/simplify meal plan
  • Counseling for parents on changing roles

Are rebellious and defiant

  • Refuse diabetes self-care
  • Hate reminders
  • Take out anger on parents or school teachers
  • Provide counseling
  • Teach how to deal with anger

Place importance on peer relationships

  • Peers take priority over self-care
  • Child hides diabetes
  • Child uses diabetes to establish role within group
  • Discuss setting priorities
  • Plan for when diabetes care comes first

Question why things happen

  • Ask “why me?”
  • May experience depression
  • Offer counseling or find peer support
  • Look into diabetes camps

Aren’t thinking about the future

  • Don’t think about long-term complications of diabetes
  • Focus on immediate concerns
  • Avoid scare tactics

Are aware of emerging sexuality

  • Wonder if they are more at risk for STDs or AIDS
  • Wonder if they will be able to have children or be good parents
  • Health care provider should talk with child

Schreiner et al. Diabetes Spectrum 13 (2): 83,2000

15-16 Year-Olds

General Characteristics

Impact of Diabetes

How to Approach

Have increased ability to compromise

  • Can make more decisions about diabetes care
  • Include teens in decisions
  • Negotiate and use behavioral contracting

Are more independent

  • Can better understand the relationships between exercise, diet, and insulin
  • Give more advanced diabetes education

Feel stressed by social, school, and family responsibilities

  • Stressed teens may eat more, which can result in weight gain or less controlled blood glucose
  • Teens trying to manage stress with physical activity may have low blood glucose events
  • Teach stress management
  • Assertive communicating training

Test boundaries and take risks

  • May try drugs, alcohol, smoking, unprotected sex
  • May skip medication
  • Educate on teen issues
  • Discuss logical consequences

Are figuring out what’s important to them

  • Are determining how diabetes fits into their life
  • Meet with a life coach or diabetes coach to help child clarify values

Are learning to drive

  • Can experience low or high blood glucose which may impair driving ability
  • Educate on safety: checking blood glucose before driving, having fast-acting glucose sources in the car
  • Drive with someone else in case of emergency

Schreiner et al. Diabetes Spectrum 13 (2): 83,2000