Partner’s Corner

Teenagers and diabetes

“My teenage son doesn’t want to take his insulin. He rebels against it as if it’s something only I want him to do, not something he needs to do to keep him alive. What can I do?” Jesca Ncube.

Dear Jesca,

Even the brightest, smartest and most driven of teens have a hard time dealing with the day-to-day demands of diabetes. Having diabetes is often the one thing that trips them up.

They feel that their freedom is compromised. They are stuck in a zone where they are constantly asked about their blood sugar and as a result some lie about testing and taking shots: they suddenly experience a sort of “freedom” by lying and getting away with it. A wake-up call is usually when they land up in hospital. Most diabetics are prepared to try and do something to prevent that from happening again.

Because we live in a fast moving world, today’s teens have little time for themselves. Many teens are stressed, tired, and often have difficulty keeping up with the things they want to do, never mind the things they don’t want to do. Teens are risk-takers and struggling for independence – within this struggle, taking care of their diabetes is definitely not a priority.

So to answer your question:

The most important thing is to stay involved.

  • Try and coach your teen into some kind of “contract” between the two of you regarding his insulin. Encourage him and make him accountable. Ask him what is helpful for you to do and what is not. Listen carefully.
  • Find a health-care provider he likes and let him be educated about diabetes and the optimal treatment. Get him to meet up with other teens who are also living with diabetes.
  • If the shots are bothering him, find out why exactly and see if you can change things to make a difference.
  • Find out if he could be a good candidate for an insulin pump. Teens love technology and they usually do very well with pumps because they are growing up in a world exploding with new technology.
  • Never be afraid to seek counseling. A teen might refuse to look after himself because he is depressed.
  • This is the difficult part: you as a parent know the importance of insulin in your teen’s life. Try to explain it to him and ask him to work with you. Baby steps.

The good news is that most teens who have periods of giving up on their diabetes care eventually mature and start to do better again. Be your teen’s best friend: best friends do not judge and always stand by you.

– Jeannie Berg, Diabetes Educator

 

 

 

Dealing with diabetes burnout

“I’m worried that my wife is suffering from diabetes burnout. She seems exhausted by her condition and uninterested in getting it back under control. What can I do?” Simon Smith

Dear Simon,

Dealing with diabetes burnout is complex. There is no “one solution fits all” because the experience isn’t the same for everyone. Each person lives with diabetes in their own way, and needs different kinds of support. Burnout is often accompanied by stress, anxiety, depression and a host of emotional states like anger, resentment, shame and guilt.

A few ideas to help your wife work around her burnout are:

  • Allow her to feel “burned out”. If she tries to hide that emotion, it just makes it worse. Denial is not good for healing. Help her think of positive things about her diabetes. For example: “At least I am eating healthy.”
  • Nurture her. Spend quality time with her. Teach her to nurture herself.
  • Get her to slow down some things in her life. The idea is for her to have more breathing space in her life so that everything isn’t related to diabetes.
  • Sometimes it also helps if she changes her diabetes management. If she is using a pump, maybe she could go onto normal injections for a while. Or if she is injecting and this is getting her down, she could follow up the idea of using an insulin pump. Maybe wearing a continuous blood glucose monitor might help take the stress out of all the fingerpricks for a while.
  • Encourage her to connect with other people with diabetes so that she knows she isn’t alone.
  • Help her realise that she must not strive for perfection, and accept that fluctuations happen, even when she is trying her best.
  • Instead, focus on her victories: what she is doing right, even the small things. Then, set some achievable goals that build on those successes.
  • Together, try to identify the barriers she has in managing her diabetes. This will help both of you to decide what she needs to change to have better control over both her diabetes and getting rid of her burnout.

Always remember that your diabetes team is there to help you. Remind her that it is never about how you fall, but about how you get up.

– Jeannie Berg, Diabetes Educator

Helping a friend through a diabetes diagnosis

“My friend was just diagnosed with Type 2 diabetes and weirdly the thing that’s bothering him most is what people will think. He doesn’t want to tell anyone because he says they’ll blame him for becoming diabetic – because he didn’t eat healthy or exercise enough. How can I help?” Shan Moyo

Dear Shan,

First of all, I think your friend is lucky to have someone like who cares enough for him to help him work through the barriers of accepting his diabetes. Because of all the studies that have shown that diet and lifestyle have an influence on Type 2 diabetes, uninformed people forget that there are numerous other reasons for developing diabetes as well. And the Type 1 and Type 2 labels also make people more judgemental.

To some people, their personal health problems and issues are exactly that: personal. Frankly, your friend doesn’t have to share with everybody that he has diabetes, but it is a good idea to let someone close to him know, in case of an emergency. One of the hardest things that newly diagnosed people with diabetes experience and fear is that those who have known you for years start treating you like you’re different. They see your diabetes and not you. But help him look at it this way: no one today would accuse someone with AIDS of giving themselves the condition. So why allow anyone to do it with diabetes?

What can you do? Be an active reader and read your friend like an open book. Listen more and talk less. Help him come to terms with his diabetes and find confidence in managing it. Don’t let him assume that others are judging him: nobody has any power over what other people prefer to think.

Finally, if your friend is really struggling with a lot of mixed emotions, remind him that it’s perfectly normal to feel that way, and that it’s okay to need some help with the burden of managing a demanding condition. And lastly, one of my favourite quotes by Lao Tzu for him: “Care about what other people think and you will always be their prisoner.”

Help him to live free and happy.

– Jeannie Berg, Diabetes Educator

 

How to deal with a diabetes diagnosis

“My son has just been diagnosed with Type 1 diabetes and we all feel like our world has been turned upside down. But he’s really struggling to talk to us (and his extended family) about his diagnosis. Any tips on how to begin?” Razan Naransamy

Dear Razan,

When a child is diagnosed with diabetes, both parent and child feel different emotions. In the beginning, parents are inclined to spend time worrying about the physical effects and the day to day management of a condition they don’t yet know anything about. The child goes through different feelings, like sadness and hopelessness, even anger and frustration.

It might help to find someone your son will confide in – even if it’s just to find out why he doesn’t want to talk about his diagnosis. It could be a diabetes nurse he trusts or a psychologist or even a family member or friend. Don’t feel bad about getting help. There are many reasons he might not want to share: he might feel isolated, depressed, afraid or even angry at you. Because you are the one in charge of the tests and shots and the policeman of what he eats or does, it might be easier to blame you. He could even be feeling embarrassed because of the sudden overload of attention.

Helping your child involves acknowledging his feelings and listening to what he says. This communication does not always have to be verbal. Writing or drawing or even making music can get your child to share his feelings.

Encourage him to actively participate in his health care management. Help him to be independent. Once he starts feeling more confident and independent, he will be more likely to share his feelings of living with diabetes. Encourage him to have fun with friends and if he starts going on outings and camps with friends and other children with diabetes he will learn from them that it is okay to talk about it.

  • Tell your son that he did nothing to deserve diabetes – it just happens. If he feels that the condition is troublesome for you or your family, reassure him that there’s no reason to feel guilty.
  • Remember that children are likely to copy the way that their parents cope with something.   Also remember that expecting a child to deal with things quickly and practically isn’t helpful to you or him. You need to set the example.
  • Build a support network that you and your family can fall back on. Be informed parents.
  • Make the most out of every day.

You and your son are on a lifelong journey with diabetes.

A good journey requires lots of planning, flexibility, curiosity, frequent course corrections, and an occasional attitude adjustment.

Make it a good one.

– Jeannie Berg, Diabetes Educator

 

Diabetes and children’s parties

My son was just diagnosed with Type 1 diabetes and I want to know what to do about children’s parties and play dates? I don’t want him to feel ‘different’ but I also want to make sure his blood sugar won’t get out of control.” Linda van der Merwe.

Dear Linda,

I’m not sure how old your son is, but diabetes at any age can be difficult. Rest assured, what seems overwhelming now will eventually become routine.

Diabetes affects a child’s emotions, and badly controlled blood sugar can make diabetics feel irritable. If your son forgets to take insulin for a piece of cake at a birthday party, for example, he could end up fighting with his friends. Talk to him about the kind of food that will be at the party and help him to make decisions about which foods to choose, and which to avoid. Make sure he has something sweet on him in case he goes low, and chat with him about what to do if he feels funny. Most importantly, let him know that you are only a phone call away.

Yes! The thought of your child going off to a party at someone else’s home may make you scared. Away from your control, over-excited by all the fun and surrounded by delicious high sugar and high carb treats. A parent’s worst diabetic nightmare. But just remember: a child with diabetes is still a child. And children LOVE birthday parties!

It’s a good idea to call the host parent and find out what sort of food and drinks are planned for the party. You can even offer to provide a platter of your child’s favourite (diabetic-friendly) snacks, so that he can share them with his friends. Let the host know that you will have your phone on you the whole time.

Lastly, try to relax. With careful planning, your son can safely enjoy birthday parties as part of his childhood.

– Jeannie Berg, Diabetes Educator

 

How to help a friend with diabetes

I would like to know to help and support a friend who has diabetes. My friend is a Type 1 diabetic and I’m not always sure how to help him in the tough times.” Markus Vorster

Hi Markus,

You have not said how old your friend is, but much of the basics stay the same. Here are 7 ways to support your friend with diabetes.

  1. First of all, treat your friend like anyone else. It is important for him to realise that his diabetes makes absolutely no difference to your friendship. If your friend is having trouble accepting his condition, be supportive and understanding.
  2. Try not to ‘mother’ him, but do encourage him to look after himself.
  3. Understand that people with diabetes are more prone to mood swings and depression than those who do not have diabetes.
  4. Learn to be able to recognise when his blood sugar goes too low, and know what to do in case he needs help.
  5. Remember, really tough times for diabetics are when they are sick. Blood glucose levels bounce up and down and this makes them feel more ill.
  6. Give him all your support by understanding his condition to the best of your ability.
  7. Get the facts and go beyond the myths and misinformation by talking to your friend, your doctor, or relatives who have diabetes.

As a friend, your understanding and acceptance are very important. The more you understand his circumstances, the less alone your friend is likely to feel.

Empathise, but never sympathise.

Good luck!

– Jeannie Berg, Diabetes Educator

Teens with Type 1

Teenagers with Type 1 diabetes feel especially isolated and alone. It’s bad enough dealing with body changes and hormonal issues, but add to that testing blood sugar, keeping tabs on what you eat and injecting yourself, as well as mood swings, and you can see why teens with Type 1 have a lot to deal with. Understanding what goes into diabetes means you can help your teen feel less self-conscious and different from everyone else.

Photo by Asaf R on Unsplash

Mood swings in people with diabetes

What can you guys tell me about mood swings in Type 1s? Happy the one day, negative the next? What advice do you have for partners of diabetics on how to handle these mood changes?” Lynne van der Spuy

Dear Lynne,

Mood swings are common in people with diabetes for both emotional and physical reasons. Anger and anxiety are normal reactions when someone has a chronic condition: it’s a lot to cope with, and at times overwhelming. Problems with poor control can cause stress levels to climb, leading to a vicious cycle of high glucose levels and fear about managing the condition. In fact, the emotional impact of diabetes is so vast that the risk of depression is doubled.

Physically, when someone’s sugar spikes or drops, it can actually produce feelings of anger and anxiety that are really out of their control. It can also make it harder to concentrate and cause fatigue, which would make anyone feel down. Stressful situations alter the body’s management of glucose, which can result in unstable blood sugar, so you may notice that mood swings worsen.

How to handle a mood swing:

  • Communication is vital. Address the issue when your partner is in a good frame of mind.
  • Explain your frustration and say that you understand mood swings are part of diabetes, but that doesn’t make it any easier. Make sure you feel heard; that’s important for your emotional well-being!
  • Ask your partner to check blood sugar during a mood swing, and correct if necessary.
  • Try to stay calm and avoid getting drawn into a fight; walk away if you need to.
  • Long term: encourage good diabetic control, and think about seeing a counsellor if the emotional issues remain difficult.

– Jeannie Berg, Diabetes Educator