Teens (Age 13–18)

Teens often struggle with their diabetes management and this is the age range when we start seeing the A1C rise. Teenagers have a lot to master in all aspects of life, and adding diabetes into the mix is challenging.

By the end of the teen years, the young adult is supposed to have abstract thinking, be able to consider future implications and consequences of their choices, and be able to comprehend the impact of behavior on their future health. But this is easier said than done because teens are also risk takers, like to explore new behaviors, and tend to underestimate the negative consequences of their actions because they feel invincible.The challenge is that most teenagers do not fully develop these skills until their 20s. Teens want so badly to be independent with everything, including their diabetes, but they still need some supervision and parental involvement with their diabetes care. This desire for independence but continued need for parental involvement often leads to increased conflict around diabetes care tasks.

The teenager needs time alone with their diabetes provider so that they have the time to discuss the sensitive topics of relationships, sex, drugs and alcohol, and driving responsibilities. All education needs to be directed at the teenager, especially if they were diagnosed at a young age.The topic of transfer to an adult diabetes provider needs to be discussed years before it will likely happen so that there is ample time to plan, prepare, and gradually transfer diabetes care tasks to the young adult.

As they get closer to leaving home, the adolescent needs to be involved in scheduling appointments, ordering their medications from the pharmacy, dealing with sick days, and trouble-shooting on their own. Many pediatric centers offer courses and groups to help adolescents learn about transitioning their care, and these resources should be sought.