Diabetes in adolescence: teenagers don't always obey all the rules

DIABETES IN ADOLESCENCE: TEENAGERS DON'T ALWAYS OBEY ALL THE RULES

What is particularly worrying for some parents is the way teenagers with diabetes don't seem to keep to the rules of proper care for diabetes. It is not easy for a teenager to keep to a strict medical regimen, and most fail to keep really good diabetic control in their early adolescent years. If it is a difficult time for them, it is often an anxious time for their parents.
In early teenage, almost all young people break their diet some of the time. Many don't manage to keep to a food plan at all even though their mothers may provide a balanced meal with the correct exchanges. The teenager has strong drives to eat and drink at times other than usual mealtimes, and an overriding appetite may defeat even the best intentions. Eating and drinking are social activities, and it is hard to avoid having the wrong food and drinks when you are with friends. There have been a number of studies made on adolescent eating habits, and these confirm what most mothers of teenagers know very well. Many teenagers like to skip breakfast or lunch. Most teenagers have a high proportion of their food as snacks between meals particularly in late afternoon and in the evening. Teenagers often develop strong likes and dislikes and many take strong exception to the family meals which their parents provide. There is considerable reliance on take-away food which can be eaten quickly with friends. It would be unreasonable to expect teenagers with diabetes to be different in any of these ways from teenagers who do not have diabetes. It is not surprising then that a regulated meal plan prescribed for diabetes will be quite unacceptable for some teenagers and for others there will be times when social demands will override dietetic considerations.
Teenagers usually dislike blood tests, and some go through a period of not doing them. If they think this will distress their parents or their doctor, they even make up results. In a recent survey of teenagers attending our adolescent clinic for diabetes, half said that they sometimes made up their blood test results when they wrote them down.
Some teenagers resent parents supervising their diabetic care - even though it is only too obvious that some supervision is needed! Attempts by parents to advise or give gentle reminders about blood tests or meals on time may be met with accusations of nagging and interference. All this may make parents confused and upset and worried: how much can they sit back and watch their child neglect his health and risk complications of diabetes in later life?
Perhaps it is helpful to understand the reason for this contrary behaviour which is so common in adolescence.

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