Diabetes: Caring For Your Emotions As Well As Your Health, Second Edition
Diabetes presents unique issues for young people with the disease. Simple things, such as going to a birthday party, playing sports, or staying overnight with friends, need careful planning.
Checking blood glucose, making correct food choices, and taking insulin or oral medication can make teens feel “different” from their classmates.
For any teen with diabetes, learning to cope with the disease is a big task.
Dealing with a chronic illness such as diabetes may cause emotional and behavioral challenges, sometimes leading to depression.
A young person newly diagnosed with diabetes will have a range of reactions and emotions. Common reactions experienced by teens and their parents include shock, denial, anger, sadness, fear and guilt. These feelings usually subside with time and appropriate support.
Common responses to a diagnosis of diabetes include:
Anxiety about the condition.
Fear of needles and multiple injections.
A feeling of being overwhelmed by injecting and other tasks that need to be performed daily .
Frustration over fluctuating blood glucose levels
Fear of experiencing hypoglycaemia (low blood glucose – potential symptoms include dizziness and feeling faint) in public
Embarrassment about their diabetes and their friends’ possible negative reactions.
Difficulty coping with the emotional reaction of family members.
The period immediately after being diagnosed with diabetes can be challenging. Emotional support offered by friends, family and a diabetes healthcare team can be very helpful during this time and can improve the way teenagers cope with their diabetes.
Living With Diabetes, A Family Affair: Practical and Emotional Support Strategies
Family Support:Managing diabetes in adolescents is most effective when the entire family gets involved. Diabetes education should involve family members.
Families can be encouraged to share concerns with doctors, diabetes educators, dietitians, and other health care team members to get their help in the day-to-day management of diabetes.
Extended family members, teachers, school nurses, counselors, coaches, day care providers, and others in the community can provide information, support, guidance, and help with coping skills.
Diabetes is stressful for both the young person and their families. Parents should be alert for signs of depression or eating disorders or insulin omission to lose weight and seek appropriate treatment.
Body image concerns and eating disorders are a major issue for many adolescents. Having type 1 diabetes increases the risk of developing an eating disorder and parents should be aware of this.
Some young people feel pressured by their friends and the media to conform to a certain body stereotype and weight.
This pressure can lead to dieting and dieting can lead to eating disorders , most commonly in girls, but also in boys. Disordered eating can lead to poor and unstable blood glucose control.
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Some teenagers will manipulate their insulin doses in an attempt to lose weight or avoid weight gain.
This can lead to diabetic ketoacidosis (accumulation of dangerous substances called ketones in the blood and urine), which is life threatening.
Disordered eating, along with poorly controlled blood glucose levels, can also increase the risk of long-term complications, such as damage to the eyes and kidneys.
If you think your child has an eating disorder or is overly concerned about their body image and weight, talk to their diabetes healthcare team or dietitian about appropriate counselling and support.
Living with and managing diabetes every day can be a struggle. Young people are commonly concerned about:
Feeling like they are a burden on the family.
Being treated differently or delicately, as if they are ‘sick’.
Coping with constant parental questions about their diet, how they are feeling and whether or not they have taken their insulin.
Getting extra attention from parents or others, which may cause jealousy among other siblings.
It’s normal for adolescents to feel sad, angry and fed up with their diabetes at times. After all, diabetes is a lifelong condition, so the tasks and skills needed to manage it must be continued over a lifetime.
If young people struggle with their diabetes management due to feeling depressed, anxious or overwhelmed, it is important to seek help from your diabetes healthcare team. A social worker or psychologist can help. In some cases, the involvement of a psychiatrist may be necessary.
While all parents should talk to their children about avoiding tobacco, alcohol, and other drugs, this is particularly important for children with diabetes.
Smoking and diabetes each independently increase the risk of cardiovascular disease and people with diabetes who smoke have a greatly increased risk of heart disease and circulatory problems.
If you as a parent are a smoker, your child with diabetes is being exposed to your second-hand smoke. Quitting now will not only improve your own health, but will improve the air your child is breathing.
Quitting smoking can be difficult. Teens who really want to quit will succeed with will power and help from others. Your doctor and diabetes health care team have experience helping other teens break the habit. Ask for their help. There may be a smoking cessation program your teen can take.
Here are some points to keep in mind about smoking:
If you are a non-smoker, don’t start!
If you smoke, quit now.
Get help from your doctor or health care team. There are proven ways to help people quit.
If there are other smokers in your house, quit together so you can give each other support.
Ask friends and family to help and to be supportive of your teen’s efforts.
Don’t give up the struggle to quite smoking! It may take several tries, but keep at it.
The day your teen stops smoking, his body will start repairing the damage done and he will be on his way to leading a healthier life.
It’s not unusual for teenagers today to be offered alcohol or drugs, and to have to decide whether they will try it. Teens with diabetes have to think about these decisions extra carefully because diabetes and alcohol or other drugs are very bad mix for their health.
Alcohol has no nutritional value (except calories), but it does have a powerful effect on blood glucose control.
Binge drinking can cause hyperglycemia acutely, followed by an increased risk of hypoglycemia.
The symptoms of intoxication are very similar to the symptoms of hypoglycemia, and thus, may result in delay of treatment of hypoglycemia with potentially disastrous consequences.
Alcohol increases the risk of severe hypoglycaemia because it:
Inhibits stored glucose release from the liver into the bloodstream.
Reduces the ability of a glucagon injection to reverse hypoglycaemia.
Can mask the early signs and symptoms of hypoglycaemia.
Can lead to confusion, which may affect a person’s ability to manage hypoglycaemia.
May delay hypoglycaemia until many hours or even a day after drinking alcohol. Together with exercise (such as dancing or sex), alcohol can increase the risk of hypoglycaemia
Affects blood glucose levels in varying and deceptive ways, depending on the content of the drink.
Different alcoholic drinks contain varying amounts of alcohol and sugar, so they affect blood glucose levels differently.
Sweet alcoholic drinks can initially raise blood glucose levels, giving the person with diabetes a false impression that they need more insulin or are not at risk of hypoglycaemia.
If your teenager has been drinking alcohol, make sure they are woken at a reasonable time the following morning to check their blood glucose level, take their insulin and eat. They may need assistance from a trusted friend or relative with some of these tasks.
Encourage your child to avoid alcohol or drink it only in moderation.
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If your child is going to drink alcohol, suggest that they:
Be with someone who knows they have diabetes, and understands the signs of hypoglycaemia and how to treat it.
Eat some carbohydrate food before drinking alcohol and every couple of hours while they are out, then before going to sleep.
Alternate between alcoholic and non-alcoholic drinks.
Choose low-alcohol drinks in preference to those with low carbohydrates.
Carry hypoglycaemia treatment and testing supplies at all times.
Test blood glucose levels, especially before bed, and continue to monitor the next day to detect hypoglycaemia.
Discuss risk reduction with their doctor or diabetes educator beforehand in regards to insulin adjustment, especially if they are likely to undertake a lot of physical activity, such as dancing.
Illicit (illegal) drugs can significantly damage health and cause death, whether your child has diabetes or not.
Illegal drugs such as;
Amphetamines and ecstasy cause dehydration increasing the risk of Diabetic Ketosis and suppress your appetite increasing the risk of “hypo’s”.
Cannabis gives you the “munchies” resulting in constant snacking and over time can cause insulin resistance.
Cocaine can cause heart problems and mood changes in the short-term and is very addictive.
Steroids will increase your blood glucose and make control more difficult. Short term use may help build muscle mass but at the cost of future health problems
For young people with diabetes, taking drugs can result in poor glucose control, poor self-care and an inability to recognise hypoglycaemia and hyperglycaemia.
Educate yourself and your child on the possible risks of taking illicit drugs.
Encourage your child to speak with their diabetes educator and other professionals with expertise in this area.
Often times, a person struggling with addiction can try to run the show, and often times become very defensive when confronted about their problem.A professional interventionist is necessary to help a person see what their addiction is doing to them and their loved ones.
Inpatient rehab programs allow someone facing a drug or alcohol addiction to get treatment tailored to their individual needs.
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