Treating diabetes well demands a long term vision. You tolerate a lot of inconvenience today in order to avoid future damage. But, have you tried lately talking to any teenager about the future consequences of anything? Be it school, friends, lifestyle choices– teenage thinking is not designed to consider long term consequences. The dominant thinking pattern in teens is omnipotence: bad things may happen, but surely not to me. Managing diabetes with this concept in mind is pretty impossible.
So now, being more aware of the impossibility of adherence during adolescence, should you, a parent, also feel more desperate? No. knowing the problem enables you to address it more wisely, using the following tips:
1. Monitor without controlling
Typical parental monitoring not involving diabetes means that parents know at all times where their child is, with whom, and when he will be back home. When diabetes joins in, parental monitoring means knowing your child’s blood sugar level, when your child last checked it, whether your child is eating soon and what… in other words, parental monitoring in diabetes is (surprise!) a lot of hard work, but it is essential for your child. First, because managing diabetes without help and supervision is so demanding cognitively and emotionally, that it is not reasonable for adolescents, with so many other developmental tasks, to do it by themselves. Second, monitoring helps your teen with diabetes feel less alone with this very demanding illness.
It is very important, however, to know the difference between monitoring and control. As parents, we should aim to know what our kids are up to, but this doesn’t mean we also intend to control their actions. Adolescents who experience their parents’ monitoring as controlling and criticizing, don’t benefit from it. On the contrary.
2. Lower conflict without punishing
Intensive family conflict worsens adherence, while lowering family conflict improves it. Raising adolescents without fights and struggles is, of course, as imaginary as walking in pouring rain with no umbrella and getting home completely dry. Having said that, there is much to do in order to make the conflict less hostile and lower the flames. It has been shown that lectures, preaching, repeated persuasion – none of these work with teenagers (or with anyone else, actually). Threats and punishment, humiliation, or any kind of violence are also inefficient (and problematic in many other ways). All these tactics only contribute to escalation of the conflict at home.
Being a smart parent means avoiding repeating yourself again and again. Say things once or twice. Respect your child’s intelligence. His or her lack of effort is not due to misunderstanding you. They don’t want to take care of diabetes. You need to find a new way (like more supervision) rather than stick to the one that has not proven itself and enhances conflict.
3. Express understanding: Empathy not pity
The challenge of diabetes is enormous. This is always true, and for adolescents, even more so. Have you told your teenager lately how much you appreciate his or her management of their illness? How amazed you are at his or her stamina? Even if you are unhappy with your kid’s overall adherence, surely there are several diabetes duties that are being met. Show your appreciation. If you feel there isn’t anything right your teen does regarding diabetes, express your understanding of how difficult this illness is to manage. How many challenges it creates. How hard being a diabetic teenager is. Don’t be afraid of talking about how hard it is. This is empathy, not pity. The leading message should be: This is such a complicated challenge. We are so proud of your handling it and will give you all the support you need in this struggle.
4. Keep a “non-diabetes” channel open at all times
Monitoring, asking, worrying, supporting – as a parent, there are so many things to do in order to manage diabetes that sometimes it seems there is no room left for anything else. But it is very important to make room: to foster the parts of your relationship with your teenager, that are not all about diabetes. This means it is important for your child to feel, that not every how are you? is actually how is your sugar?.
Tell your teen about yourself, your work. Ask about their friends, their day, their studies. When you’re focused on getting from one blood sugar measurement to the next, trivial conversations and small talk may be forgotten. They must not be. Suggest doing something with your teen: a movie, bowling, bicycle ride. Since they are teenagers, they will probably refuse, but this is a way to let them know you are there and that they are important to you not only in terms of their physical condition. Who knows? You may even find yourself spending some quality time together.
5. Share responsibility
Parents tend to expect their teen with diabetes to be independent. This is very understandable. Your almost-a-grownup child chooses her own clothes, friends, music, and decides how to study or sleep. It is very natural to give him the keys not only to the car, but also to the insulin pump and the glucometer… or is it?
Studies show that the best glycemic control of adolescents is achieved when diabetes responsibility is shared by parents and adolescents. Diabetes is just too much for one person, and more so when this person is young.
So, as exhausting as it may feel, there isn’t really much to do other than to stay there, monitor, ask, support and very gradually transfer diabetes tasks to your teenager. Until when? When will he or she be on their own, concerning diabetes? No one can really say, but not before they are self-reliant in many other ways.