Summary: Type 1 Diabetes can pose a significant challenge for adolescents due to hormonal changes, demanding schedules, emotional turmoil, body image concerns, substance use, and social pressures. Healthcare professionals and parents can support adolescents in maintaining optimum blood sugar levels by actively involving them in their care, providing education, leveraging technology, and offering social support through support groups. By working together, we can ensure that adolescents with Type 1 Diabetes receive the necessary support to manage their condition effectively, reducing the risk of long-term complications and promoting positive mental health.
Adolescence is a period of significant physical, emotional, and social changes. It's during this time that Type 1 Diabetes, the most commonly seen endocrine disease among this population, can pose a significant challenge. (1) Adolescents who need to manage Type 1 Diabetes face added complexities during the already daunting process of transitioning to adulthood. While diabetes can affect people of all ages, adolescents are particularly vulnerable due to the unique challenges of this developmental stage. This article explores why managing diabetes in adolescents can be demanding and how we can overcome these hurdles.
The hormonal changes that take place around puberty lead to a decrease in insulin sensitivity- i.e, they decrease the body’s ability to utilize insulin effectively. (2) This may result in elevated glucose levels and erratic blood sugar fluctuations for teenagers, which are expected to persist until they attain full growth. Up to 70% of adolescents who have diabetes do not have optimal control of their disease. (3) Gaining insight into the setbacks that adolescents face in managing their diabetes is the key to preventing long-term complications caused by high blood sugar levels. Some of the struggles diabetic teenagers face are-
Transition to self-care: Adolescents with diabetes must transition from a pediatric care team to an adult care team, which requires a lot of self-management. This shift can be challenging for adolescents as they adjust to taking on more responsibility for their diabetes management. Typically, adolescents start handling their diabetes independently around the ages of 16-18, which means they rely less on their parents for day-to-day assistance. However, this transition can be difficult since they lack experience and may make mistakes.
Demanding schedules: Adolescents juggle school, extracurricular activities, and social life. It can be cumbersome to keep track of glucose levels, insulin, and diet while dealing with an overwhelming workload.
Emotional turmoil: Dealing with diabetes can be a lifelong challenge for adolescents, and it's not uncommon for them to feel a range of negative emotions, such as sadness, anger, and frustration. Over time, this can lead to depression or anxiety, decreasing their motivation to keep their blood sugar levels under control.
Body image concerns: Teenagers often feel the need to fit in with their peers or follow media standards for the "perfect" body, which can lead to unhealthy eating habits. Adolescents with diabetes are particularly vulnerable to developing eating disorders, which can cause their blood glucose levels to become unstable and too high. (4) Some teenagers may try to lose weight or prevent weight gain by altering their insulin doses, which can result in diabetic ketoacidosis.
Substance use: Peer pressure or wanting to experiment can push teenagers to try drinking. However, for individuals with diabetes, alcohol intake can pose significant risks, especially because it can cause hypoglycemia or low blood sugar. Due to the effects of alcohol, individuals may not recognize the signs of low blood sugar levels, making it challenging to manage the condition effectively. Moreover, others may mistake the symptoms of hypoglycemia for drunkenness, which can lead to a lack of necessary assistance for people with diabetes.
Social pressures: Teenagers may hesitate to take insulin injections in front of their peers at school, possibly because they fear being bullied or being perceived as weak. However, delaying insulin administration can lead to ketoacidosis. Teenagers with diabetes also overlook their dietary needs when socializing with friends, as they may feel self-conscious about following a special diet. This can lead to fluctuations in blood sugar levels that can have serious long-term consequences.
Finding ways to navigate these obstacles
To tackle these issues, healthcare professionals and parents can work together to develop strategies to support adolescents in maintaining optimum blood sugar levels.
Actively involving adolescents in their care: By involving adolescents in the decision-making process, healthcare professionals can help them feel more invested in their treatment and more motivated to adhere to it.
Education: Adolescents need to understand the importance of managing their diabetes and the impact it can have on their long-term health. Providing education and support about diet and regular insulin administration through individual counseling, group counseling, or online resources can have a positive impact on their attitude toward self-care.
Leveraging technology: Adolescents are often early adopters of technology, making it an effective way to engage them in diabetes management. Mobile apps, for example, can help adolescents track their blood sugar levels, medication schedules, and food intake. Wearable devices, such as continuous glucose monitors, can provide real-time data on blood sugar levels, helping adolescents make informed decisions about their diabetes management.
Social support: Support groups can provide emotional support, reduce feelings of isolation and provide a sense of belonging for adolescents with type 1 diabetes, thereby promoting positive mental health. (5) Additionally, they offer a chance to establish meaningful relationships with peers who share similar experiences, ultimately reducing embarrassment tied to their diabetes.
By working together, we can ensure that adolescents with Type 1 Diabetes receive the necessary support to manage their condition effectively, reducing the risk of long-term complications and promoting positive mental health.
DeFronzo R, Ferrannini E, Zimmet P, Alberti G, Eds. International Textbook of Diabetes Mellitus. 4th ed. Chichester, U.K., John Wiley and Sons, 2015
Written by: Dr.Manognya Chekragari