Rebelling teen

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Permalink Reply by tyler on October 31, 2009 at 8:45am

Well all I can say is I just turned 14 & have it for 3 1/2 years & I am just starting to get very , very tired of it . It is no fun to have to keep checking your blood cause you feel funny (low or high) . Mom said this is the first time I have complained . I just want to be like all the other kids ,bunch my friends going out tonight ,I went last year but they were all eating candy all night , so I said to them " well I am going to gone on home " ,had to get home to take Lantis shot anyway , so probably wont go tonight . . So unless you got the big D when you were a kid you really dont know how it is . I know I am tired of it & I got the rest of my life to live with it . Just thought I would give you a teens view .

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Permalink Reply by Dave Shikiar on October 31, 2009 at 8:52am

Tyler- I really appreciate your point of view. I know he is sick and tired of it, and the realization of it being a life long thing is probably more of a reality now. You are right, I don't know exactly how it feels to have D and be 13.
But you should know us parents, never stop thinking about what you kids are dealing with either, and that's why we get so concerned about high's and lows.. Thanks...
Don't feel bad about Halloween- we always try and do different things on this day..

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Permalink Reply by tyler on October 31, 2009 at 9:34am

Thats what my mom says to ,but you know we know that but it still dont make it any easier ! LOL , but as my mom say's IT IS WHAT IT IS ! If he wants to email me he can lester664@bellsouth.net

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Permalink Reply by Katie on October 31, 2009 at 8:47am

Hi Dave,

That sounds like a tricky and frustrating situation. Speaking as a formerly "rebelling" against diabetes teen, it's good that you are concerned and looking out for him. I don't think that taking away his control will help, because it is possible (although of course I can't know) it is a need for more control and independence that is causing him to rebel in the first place. I would suggest approaching him more as a concerned partner in his diabetes care - trying to control it could result in authority battles. His struggle for independence, especially as a teen, should be respected. But of course it is important he controls his diabetes - so maybe you can try to find some middle ground.

Can you explore with him more what he is scared of with lows? Why his attitude towards his diaebtes changed? What else might be going on in his life that is affecting his diabetes control?

There's no simple solution, but I'm glad to see you are looking out for this because I know lots of now adults with type 1 who could have used more interventions as teens!

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Permalink Reply by kAiTs_mOm on October 31, 2009 at 9:43am

Yes, actually, I do.

My daughter, Kait, is a T1...5yrs. She's rebelled in the following ways: not checking bgl, not taking insulin, not counting carbs, not checking ketones, not writing down her data, etc.

I was at a loss because it seemed that no matter how diligent we were, her bgl was always high. For example, it is extremely rare for her to wake up with a bgl lower than 300mg/dl. In August (beginning) she was taking 16u of Lantus by the end, she was taking 28u's. Her food/carb ratio was 1 to 5 for breakfast and lunch but 1 to 4 at dinner. Her morning bgl's were still over 300. I’ve also tried the following: no red meat in her diet, we only eat low fat with some diabetic recipes tossed in here and there, mega fruits and vegetables throughout the day, etc. Basically, we follow the FDA food pyramid.

Anyway, it's very frustrating. I imagine, for her, the feeling is like someone trying to lose weight...you do really great at self-control until you step on the scale only to see that, after all your sacrifice and hard work, you’ve gained a pound. In response to the scales declaration, most people say why bother...and stop dieting. Unfortunately for diabetics, they can't stop diabeticing. Lol!

Well, Kait started on a Novolog JR pen before she learned to give herself shots via a syringe. So, since I had 5 vials of Novolog just sitting in my fridge, I hid all of her pens and made her take her insulin via the syringe. This meant she had no freedom because she could only get her insulin if I gave it to her. It really worked too...for about three vials...cause at that point, she taught herself to use a syringe. Ha Ha! When there’s a will there’s a way. I’d forgotten about that. Anyway, she's doing great now! I check her meter and we discuss her numbers, nightly.

If you're not in a situation to do this, try poker chips. Basically, he gets 1 chip for every check, maybe if he’s dispensed his insulin correctly for the day, he can have 5 chips, etc, etc. At the end of the week, if he has the required amount of chips, he can buy that “something” he really wants or he’ll get “specified amount of $” to put toward that “something” he really wants.

I have a friend who went as far as embarrassing “child” in front of friends. Telling them “child” is not taking care of self correctly and what the consequences are. Yes, the peer-pressure card worked. “Child’s” friends lit into “child” and then started asking “child” about checks, insulin doses, carb counting, etc. A mom’s gotta do what a mom’s gotta do, right?

Think outside-the-box. You know your son and what motivates him. Use that knowledge to come up with a plan that will get him to do what he needs to do. You must, however, stay on top of him, daily.

Good Luck!

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Permalink Reply by MelissaBL on October 31, 2009 at 12:30pm

We have some really great discussion threads on this topic. Like this one.

As a former teen type 1 myself, the first thing I want to help you understand is that this is normal behavior, and while potentially destructive, not necessarily so in the long term. He is learning to own his health condition outside of your influence. It's not rebelling as much as it is coping and exploring.

My suggestions are to NOT take his pump away (which he will resent and which will make his control harder), do NOT embarrass him in front of people, do NOT threaten him with complications, etc. If anything, what he needs is to be able to meet with his doctor or educator and talk through his issues with his management without you there. He needs to see that they expect him to manage his diabetes and to find ways to work through his issues with fear of lows, overbolusing, etc. His medical team is equipped to handle this.

My other suggestions would be to let him lie about his school time numbers, but when he's home, have him test in your presence so you can help instruct him on the proper amount of insulin to take. Tell him you're there for him and have him test after dinner as well at 1 hour and 2 hours so you can show him that the insulin you suggested is keeping him in range after meals. He needs to see that the additional boluses are unnecessary. If he is truly suffering under this constant fear of lows, he needs to look into a CGMS (Dexcom, Minimed, or my favorite - the Navigator) so that he can see in real time that he is in range and can see that he doesn't need the extra bolusing.

One thing that diabetics and their doctors have always had trouble convincing parents of is that a blood sugar level is just a number. You see the number and take the appropriate corrective action. It's not a result of a "bad" behavior, it's not worth lying over, and it should not elicit an emotional response from the parent.

It should be as detached as "Okay, you're 50. Why don't you have 4 glucose tabs or this juice here? I'll get it for you." Or "Okay, you're 312. Let's take a bolus and wait another half hour before we sit down to dinner." There should be no "what did you do?" or "why are you high?" Because the honest answer is "Because it's unfair that my pancreas doesn't work, Dad. I don't feel well right now when my blood sugar is out of whack and I don't want to have to defend myself right now. I'm just trying to feel normal in a world where I'm not."

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Permalink Reply by Dave Shikiar on October 31, 2009 at 3:17pm

Thanks Melissa. Those are some good words of advice. We rarely overreact to numbers, but can't lie, I have said
"wonder why that is so high". Now that we can download his numbers, we see at school especially, he's not putting in the suggested insulin for carbs but tiny amounts all day..to keep from getting low, getting embarrassed etc...we know there is no clear cut answer to this, but the suggestions you made are really good and we will keep them in mind and use them. It's always an ongoing process, it's just this is the first time (the past 2 months) that we have seen this .. Thank you.

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Permalink Reply by kAiTs_mOm on October 31, 2009 at 3:02pm

Allow me to clarify:

My daughter, Kait, has been a T1 long enough to know the short-term and long-term consequences and complications that come from not taking care of her diabetes.

She was given this information by her pediatric endo (when she was diagnosed and every three months the topic is revisited), by her pediatrician (I always bring copies of her log book and we discuss her diabetes at each and every appointment, regardless of the reason for the visit), by her Pediatric Psychiatrist who specializes in working with children with chronic illnesses (we saw her once a week for a year and I can’t tell you how many times this topic was discussed), by her dentist, her pediatric ophthalmologist (she visits each of them twice a year), by the school nurse, my husband and me, her siblings, grandparents, etc.

Kait is a smart little cookie! She learns fast and knows the ins-and-outs of her diabetes. Therefore, when she began to rebel, I knew it was a typical teenage rebellion – not because she wasn’t aware of the consequences of her actions. She is a teenager that has diabetes and she just wants to be “normal”. She doesn’t want to have to worry about bgl’s, shots, highs and lows, or counting carbs, etc. First and foremost, she is 15 years old so, even with diabetes, her brain functions like a 15 year old.

She knows that with poor care she can lose her eyesight, a limb, a kidney, and possibly even her life (look at all the people who have told her so) but in her teenage mind she is immortal and it will never happen to her. She knows she will always have diabetes but she chose not to take proper care. As her parent, when I see her doing herself harm –whether in the short term or the long term- it is my responsibility to step in. I must guide her in the right direction!

Although I hid her pens from her, my daughter went along willingly. After all, she didn’t have to make food, measure food, count carbs, give herself shots, etc. Honestly, she never had to “think” about her diabetes. The only thing she had to do was check her blood sugar. At first, she thought it was the greatest thing that ever happened to her, but 3 vials of insulin later, she realized that she was more independent and had more freedom when she cared for herself. That’s when she taught herself to give shots and that’s when she, once again, took over the responsibility for her diabetes. During that time, her A1C went down from 10.1 to 9.2. Kait was ecstatic!

My actions allowed her to work through her issues while at the same time making sure she was well cared for. As I mentioned earlier, you need to know your child and what motivates them.

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Permalink Reply by Jan on November 4, 2009 at 11:56am

DN will be turning 13 very soon and I have recently received a wake up call that she is indeed angry at having D, though the anger is expressed only when the media portrays D in a negative fashion; she takes this personally. Don't take away his pump, as he can rebel and not bolus if he uses injections also. Makes no sense to me, as the pump can ensure better control. I would have him go to the nurse before lunch and before he gets on the bus so she can watch him bolus for lunch and/or correct high or low blood sugars at these times. Then I would supervise the care when he is home. When he is out with friends, you will not be able to monitor him. But if he is at least bolused for breakfast, lunch and dinner, and you can get the overnight numbers, that is a start. If he wants more freedom, he will have to be more responsible. I would make sure he has a source of sugar handy in his pockets at all times for lows. I do run her a little higher while at school because I don't want her to fear lows while at school. Does he know how much to cover IOB two or three hours after eating to prevent lows? Sorry my answer does little about the problem of turning his D over to him to manage; my instinct is to take back management as much as possible until you can hand it back to him safely.

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Permalink Reply by Rachel Johnston on November 4, 2009 at 1:02pm

i was a rebelling teen in high school. i started doing 'bad things' at age 17. but i stopped when i was about 18.
i'm not a parent, but i am a teenager. so i would suggest not to hover over him. treat him like an adult.
i agree with melissa on everything :)

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Permalink Reply by Dave Shikiar on November 4, 2009 at 1:08pm

Thanks all! THis is all helpful. We're not hovering just worried about what he's doing to himself long term..however can't worry about tomorrow to much.

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Permalink Reply by Kim on November 4, 2009 at 1:35pm

I think everyone goes though this rebelious state. I know I have plenty of times. Every so often it overwhelms me and i take off my pump and go to shots and lets say my numbers are aweful. After a while though I get over it, hook up my pump, and get on with my life.

Im sure he will get over it like most everyone does. The one thing I suggest is do not threaten him. My mom would always tell me how my legs are going to be cut off and I was going to be put on dialysis. She even went as far a taking me to a dialysis clinic to scare me. This.. excuse my language....just pissed me off and made me more rebelious. She finally quit the treats and instead of using scare tactics started to ask what she could do to help. She would ask if she could record my numbers in my journal, or she would count my carbs in my meals. She would do everything she was able to do to help. This sounds a little lazy on my part but I finally realised what all SHE was putting into my care so why shouldn't I.

I wa diagnosed at 18 and really didnt get to go through the whole teenage year, thank god, but I can only imagine. Just let him know you are there for him and he will pull though.

Oh and I used to keep my sugars high because I was scared with lows. I had a bad experience and have gotten to a point where I do not realise Im low until its to late. I know they are expensive and there is insurace hassle to go though, but me getting a cgms was the best thing ever. I wasnt scared to take the correct amount of insulin.

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