Challenges

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Sexual identity and independence are challenges for many teens and their parents. For teenagers with diabetes, they present some special issues. The demands of self-care also can create unique pressures. To develop a sexual identity, a person has to accept his or her own body. While this is difficult for all teenagers, type 1 diabetes makes it even harder. After all, successful people in movies and on TV are shown as young, beautiful, and physically perfect. Teenagers with diabetes know they're not perfect. They wonder if they'll be accepted by the opposite sex and by their peers. Sometimes, fear of rejection will cause them to isolate themselves from their peer group. But isolation is even worse for self-esteem. If this happens to your child, you should try to break this potentially damaging cycle.

To achieve independence, teenagers often form bonds with their friends. But peer groups require conformity, and conformity creates conflict for teenagers with type 1 diabetes. How can they act just like their friends (for instance, getting behind the wheel of a car without checking their blood sugar first) and still keep control of their type 1 diabetes? Helping your child feel comfortable with the boundaries of his or her type 1 diabetes management program can be a positive step in dealing with peer pressure.

Adolescents are expected to become totally self-sufficient in their type 1 diabetes routine. While this self-reliance helps build confidence, for some it creates another kind of pressure and anxiety. When their blood sugar levels go out of controlÑin spite of their best effortsÑthey may feel frustrated, weak, and inadequate. They may react in one of two ways: denial of the disease, or with aggressive behavior, which may be acted out through food binges or skipping their insulin.

It is important that you and your teenager understand the dynamics of blood sugar during the teenage years.

The Physical Challenges

One of the most frustrating and persistent problems during adolescence is the inability to control blood sugar. Research has shown that physiological changes are at work. It is believed that a hormone called Growth Hormone (GH), which stimulates the growth of bone and muscle mass during puberty, also acts as an anti-insulin agent. Moreover, falling blood sugar stimulates the release of adrenaline, which in turn triggers the release of stored glucose. The result: blood sugar levels that swing from too low to too high.

You and your teenager should both realize that poor blood sugar control is not all his or her fault.