When Type 1 Meets The Teenage Years
School, Sports and Growing Up With This Disease
As kids grow up, they slowly become more and more independent. This is a time when they are taking on responsibility for their own schedule, homework, and in the case of type 1 diabetes, their own health. This transition is rarely easy for parent or child, but we can’t let the added challenges of type 1 diabetes hold a teen back.
This is a time of big changes to both body and lifestyle. First, there are the physical effects of puberty on type 1 diabetes. Both boys and girls often experience an increase in appetite with puberty, and more appetite means more insulin. Plus, they’re growing and that can also increase the need for insulin. Parents who once managed their child’s eating with a ratio of one unit of insulin for every 30 grams of carbohydrates are surprised when suddenly the same child needs one unit of insulin for 10– 15 grams of carbohydrates.
To complicate matters, the sex hormones (estrogen and testosterone), the hallmarks of puberty, work against insulin. While insulin lowers blood glucose, sex hormones raise it. Stress hormones, such as cortisol, also raise blood-glucose levels, and there can be a significant amount of stress experienced by a teen.
Second, the emotional and social aspects of puberty can make managing T1D more difficult. This is a time when kids would much rather be with their friends than deal with type 1 diabetes. It can be tough to figure out whether it is the biology of puberty or the result of teens not properly managing their blood sugar (or both) that is causing a high. Teens have a lot on their minds and their preoccupations can lead to forgetting boluses/injections, blood-sugar checks, necessary supplies and more.
While trying to prepare children with type 1 diabetes for independence, parents also have to make sure that they have everything they need. Because one thing is for sure: Children going through puberty do need increased daily insulin. With all the changes going on, it’s good to talk to your medical team about any sudden and unexpected spike and come up with a plan.
As kids get older, school can become more demanding ─ and that’s before adding a health condition like type 1 diabetes. More and more studies are confirming what people with type 1 diabetes have long known: a low, high or big swing in blood sugar really does affect the ability to focus.
So when you consider that type 1 diabetes is difficult to “stabilize,” how can you help your teen perform at her best in an educational setting? A teen’s 504 plan can include a section that allows him or her to delay to stop a test if their blood-sugar level is too high or too low. In a perfect world, this means the teen will check blood sugar before any test. But for most teens, the last thing they want to do is feel different from everyone else or draw attention to their disease. That’s why it’s important to have the 504 conversations at the start of the year, so they can focus on being at their best for tests, rather than having to explain type 1 once again.
Sports Teams and Other Extra Curriculars
Being a part of a group, be it for sports, music, or anything else means making a commitment to the entire team. For those with type 1 diabetes, that means trying to stay on top of their disease so they can focus on the game. It helps for teenagers to run through a quick checklist:
Do you have the supplies and glucose you need with you? Always make sure your child has glucose, a meter and insulin at any event. You may want to ask to have the school athletic trainer (most schools have one on duty during afterschool sports) trained in administering glucagon, just in case. Exercise can affect blood sugar during and long after exercise so it’s important to be prepared.
Do you have the sports gear you need with you? Type 1 diabetes is not an excuse for what the coach may demand of the players on a team. Make sure you are reasonable about the rules and expectations and allow for some not-so-perfect episodes, but treating them differently from other players won’t help in the long run.
Do you have control over your blood sugar? Blood-sugar control (or lack thereof) can impact performance. Be it on a stage or a sports field, in a pool or on a track, people with type 1 diabetes perform better if blood-sugar levels are within a certain target range. Find examples of successful athletes and performers to share with your child, like Olympic swimmer Gary Hall, NFL quarterback Jay Cutler, or American Idol finalist Crystal Bowersox, all of whom have spoken publicly about balancing their high level of success with type 1 diabetes management. Remind your teen that for the sake of the team or the cast of the play, he or she should try to know what’s going on with her type 1 diabetes at all times.
Are you ready to speak up when you need to take care of yourself? For the first weeks of any sport, you may need to ask (or beg) your teen to check a few more times than usual and experiment with things like Gatorade or similar sports drinks. Let your teen know that the goal is to find some patterns that he will be able to use as a good starting point for each practice and/or game. Acknowledge that it may be annoying, but in time, it will pay off when it helps your teen to perform the best he can at his activity.
Are you ready to handle this on your own (and as a parent, are you ready to let them)? While the fear in every parent tells them they probably should be at every practice and game, this might be a good time to let your teen begin to deal with such situations on his own. Particularly during practices, teens may not want you hovering about. Take some small steps toward letting your teen handle his activities independently. And remember, if a day goes slightly wrong (a high or a treatable low blood-sugar), it is not a sign of failure. It goes with the territory. When a situation is managed safely, your teen is moving toward independence.