What might be happening when your teen isn't dosing for lunch

Sweet Talk for Parents of Kids with Type One Diabetes

If you’re looking at the data on diabetes management based on age, you see a big camel’s hump in the graph when you get to the teen and early 20s. At these ages, kids just don’t do as well with managing their T1D — and it shows in a1C outcomes. The average a1C in this age range pops up to the mid 8s. But even though that may be normal, it certainly doesn’t mean that we parents feel comfortable with it.

Cue my conversation for this week’s episode with Jo, mom of a 14-year old who was diagnosed about a year ago. After talking about the oh-so-familiar challenges that Jo and her son have struggled with in this first year since diagnosis, we started unpacking how her son’s lack of lunchtime dosing isn’t just “reckless.” In reality, it makes a lot of sense.

For this 14-year old, as for many of our kids, giving insulin is more about the social discomfort and emotional weight that comes with managing a chronic illness in front of peers. Consider it this way: at 14, fitting in and feeling normal is almost everything. Giving that shot — and maybe even punching numbers into that pump — can feel like a glaring spotlight on differences. Thinking about it like this allowed Jo to see her son’s behavior not as reckless, but as a very human response to the pressures of teenage life with diabetes.

With that as a backdrop, I encouraged Jo to shift her focus from frustration to acknowledgment of her son’s successes. Despite the struggles, he’s managing a lot more than she sometimes gives him credit for — bottom line is that he’s dosing whenever he’s not with friends, a big win. I also invited Jo to explore this issue with her son through open and non-judgmental conversations. Ultimately, while we should never unbuckle the “diabetes seatbelt” and it’s important to try to keep numbers in range, it’s equally important to create a safe space for our kids to express their feelings and to find ways to manage diabetes that align with their need for normalcy and independence.

Hope you enjoy the show!