Advice from an Expert Low Carb D-Mom: How to Parent a Teen with Type 1 Diabetes


One of the questions I frequently get asked in my work as a low carb diabetes advocate is why I’m not a “rebellious” teen. There is a general assumption that I must be ignoring my blood sugar, skipping boluses, or eating junk food, just because I’m a teenager. But because my parents helped me develop the skills I’ve needed to accept and manage my diabetes without anger or resentment, I haven’t faced “rebellion” issues.

To celebrate Mother’s Day, I asked my mom, Roxanne Dikeman, PhD, and licensed psychologist, to sit down for an interview with me about parenting a teen with diabetes. My mom and dad have always been a huge part of my diabetes management and my primary emotional support network. And much of my mom’s wise approach to diabetes care has been guided by her professional experience. I think she has great advice, and I’m excited to share it with you.

This article is dedicated to all the moms out there!

I’m sure my diagnosis was terrifying for you. How did you process it?

Your dad and I allowed ourselves to be worried and sad for a moment, relying on each other for support. Then, we made the firm decision to adjust our mindset. We rolled up our sleeves and got into problem-solving mode.

We decided to get educated. We read everything we could and found the Diabetes Solution book by Dr. Bernstein. Soon after, we had a family meeting, including your 5 year-old brother, and decided together that we would change everything about the way we eat. Together, we crafted a family plan and committed to a unified low-carb food and diabetes management plan.

Have you ever been worried about teenage rebellion, and how it might affect my diabetes care?

There are so many technical, medical, social, emotional, and behavioral challenges for a Type 1 teenager/young adult to learn. It can feel overwhelming, but you’ve said many times when asked that ‘rebellion’ never occurred to you.

We understood early on that developing and implementing a joint diabetes management plan would solidify your sense of well-being. The goal in our family partnership was always to hand over the torch to you, so that you could be fully independent and intrinsically motivated to self-manage your diabetes as a young adult.

With your input guiding the process, we worked at your pace and discussed your readiness to take on diabetes tasks at every stage. Over time, you started managing your boluses, packing your insulin for school, and making all self-care decisions for the entirety of the school day and athletics.

As you mastered each micro-goal, we could clearly see your confidence and independence growing.  We loved seeing you seek out more ownership and celebrate each step of your success, mastery, and independence. My guess is that another reason you didn’t “rebel” is because of your focus on helping others. You chose to focus on gratitude and spend a great deal of energy and time helping other children, teens, and families through your internships and presentations.

How can parents help their teens navigate the social challenges of Type 1?

We realized that you would need to navigate many social scenarios and challenges that we would have absolutely no control over. That was incredibly scary as a parent.

One thing we could do was nurture a healthy mindset. We could teach you positive coping skills. We could work through our own fears and be good role models.

Identifying potential barriers or challenges to success and problem-solving were key.

We spent time thinking through difficult scenarios proactively as a family, such as how to keep insulin cool at a beach party, or on the football field, and what to eat at a barbecue or potluck. Self-advocacy was also a critical skill to help you build. We prepared you to be able to navigate challenging social scenarios, whether it was eating low-carb foods in the cafeteria or at parties, administering insulin shots or glucose tabs in front of friends, or explaining your Type 1 diabetes to classmates.

How did you balance taking my condition seriously with the wish to give me a sense of normalcy?

Initially at diagnosis, we all acknowledged our high anxiety levels within the family. Our goal as parents was not to encourage you to “disregard” or “not think about” your diabetes, as this would only escalate your anxiety without allowing you the opportunity to process and discuss your concerns. We decided to help you on your journey to an integrated and healthy identity through acceptance, developing appropriate expectations, and establishing a reasonable diabetes action plan.

This allowed you to take ownership of your health and make informed, rational, and realistic decisions. Decisions without consequences do not exist. You understood the horrific short and long-term consequences of uncontrolled blood sugars, which only strengthened your commitment to a low carb approach to diabetes management that generated concrete, measurable glycemic success.

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Robert Conley
Robert Conley
2 years ago

Thanks for sharing this David. Its a beautiful testament to the challenge t1d presents to moms, and how the strength and critical thinking of excellent parents can yield extraordinary children, who then go on to help make the world a better place for others living with type one diabetes – like my son. Thank you Dikeman family, and happy Mothers Day Mrs. Dikeman.

Sysy Morales
2 years ago

Beautiful example of wonderful parenting. I think this mom is exactly right about how we can approach type 1 diabetes or any challenge with our kids. The powerful combination of parental modeling (removes the possibility of hypocrisy and shows, quite literally, the way) and supporting a healthy development of agency within a child (so they can steer their own ship successfully) is the key to effective parenting. I have a daughter with type 1 and my husband and I have implemented the same parenting approach as the Dikeman family and our daughter has not rebelled either. We follow the same… Read more »

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