From a School Nurse in Iowa, USA:
I have a 13-year-old female 8th grade student who has Type 1 diabetes, diagnosed when she was approximately 8 years old. We have always had somewhat of a problem with her not following her eating guidelines, not checking her blood sugar at required times, etc. She tends to run high in blood sugar rather than low. My question (and that of her mother) is are there any ways to work on compliance with a teenager that have shown some success? This student has been known to lie about what her blood sugar is--both in school and to her mother. We are quite concerned that she doesn't understand what she is doing long-term to her body--even though she has attended camps and really has plenty of knowledge. It's the old teen-age attitude of "it won't happen to me"! We would welcome any suggestions!
There is no one method that works with all teens. As you mentioned, most teens don't worry much about the future, and all teens will have problems with compliance - some more than others.
I think the most important thing is to keep open the lines of communication between the teenager, her parents, and school personnel. You may not be able to force her to control her blood sugars as well as she should, but lying should not be accepted and should be handled the same way that you would handle if she lied about something else important not related to her diabetes.
Although you can't force a teenager to take good control of her diabetes, the parents can tell her that unless she demonstrates that she can be trusted, they might not be able to allow her to participate in activities that require her to be responsible for herself, especially activities away from home. Although they can't force her to take care of herself, they can't impose on others to be responsible for her away from home if she doesn't do her part.
Again, I would focus on being honest about the blood sugars and trying to work with her parents, physician, dietician, and therapist if necessary to improve her control. I would not recommend setting a particular blood sugar as a goal, rather honesty and responsibility. Some teens may be afraid to admit their blood sugars are out of control.
It is important to also keep in mind that many teenagers will be very non-compliant with their diabetes when they are troubled by something else in their lives. If the situation seems out of hand, referral to a social worker, psychologist, or psychiatrist may be helpful.
Original posting 16 Mar 97
Last Updated: Tuesday April 06, 2010 15:08:52
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