FUDiabetes

How do you influence your teen's diabetes management?

I’m not sure how parents make those kinds of decisions for their teenagers. I have a hard time picturing what my parents could have done to manage my diabetes better than I was without me rebelling severely. I bet there are parents on here who have dealt with this.

Do you ground your teens if they don’t manage their diabetes well? Or is there a reward system in place if blood sugars stay within a certain range? Kids just naturally become pretty autonomous at that age (e.g. many non-D parents worry about their kids drinking or doing drugs, but they can only do so much to control that).

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There are many ways to get to your kids and get them to curb their behaviors. Our favorite, and most effective, is removing electronics from their lives. In this day and age there isn’t anything that sucks more to kids (at least mine) than removing their computers/laptops/phones/tablets, etc., from them for a certain amount of time.

As much as we hate removing those things…doing so, again, for our kids, is very effective. Having said that, though…I hope to raise Liam with the kind of awareness and understanding of how important managing correctly is and I hope that if he witnesses it by example (which is how I try and teach all my kids lessons in life about) in how his mother and I manage him, that he’ll naturally want to make us happy and do what’s right because he cares not only about us, but about himself as well.

But you are right…once they get older, they are much more difficult to manage so I may be living in fantasy land with my ideas of how I envision things being. I know with my other children our ways of dealing with unruly behaviors work great.

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The OP was about sleep time decisions, and whether your teens manage their D at night. I find your topic also difficult and super interesting,so I’ll split the thread!

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That’s true. My parents method of discipline often involved escalated grounding (starting with computer, tv, then transitioning to months without the car) until we did whatever they wanted. That created all sorts of problems with resolving confrontations (then and later in life). I can’t even imagine how that method would’ve impacted my diabetes management, had it been employed.

I suppose setting defined boundaries in advance while no one was upset or angry could potentially result in the teen still feeling like they had some control and a voice in the diabetes management decisions. Which might result in them making an effort to follow those decisions.

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Is your child with diabetes a teenager?

Glad we have a pro here :wink: Impart your words of wisdom!!

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This is a very difficult line for us to walk. We are right in the thick of it, right now, since my son is a precocious 13.5 year old, who has been in puberty for a year.

I can’t force my kid to do anything he does not want to when I am not around, even if I want to. But, really, my goal is multi-fold:

  • I want to turn his body over to him when he is of age as unscathed as possible from the accumulating damage of diabetes
  • I want his BG managed day to day as best as possible according to the above
  • I want to teach him to manage it himself, so that he will do a good job when he is on his own
  • I want him to survive college and young adulthood: survive with his life (I am using the precise wording I mean here: just survive through college is a goal of its own).

So I cannot afford to make diabetes a point of contention between us. I am a directive person, but this is something I sometimes tiptoe around.

What we have done:

  • We have never sugarcoated diabetes. I have explained to him, from day 1, that this is something that he can die from, that there are horrific complications that are possible, but that he is likely to avoid this fate if he does a good job at managing it.

  • We have told him that diabetes is like a savings account. You start with a certain amount of possible highs in your account. Every time you have a high, you deplete the account. When you get to zero, you get complications. There is no way to fill the account: it only goes down.

  • We speak to him like a full adult at all times about D, never like a child. And I go in detail about all the scientific issues we ever discuss, as if he was a scientist himself. Since I have always done that (not only about D), he is quite up to speed on these discussions, and holds his own.

  • From the moment he was diagnosed, we have let him make the ultimate decisions about dosing. I never override him. But I discuss the options and decisions with him from a technical point of view, like two technical experts would. He often takes my opinion, but I have also found that his gut feel is better than anyone in many decisions.

  • We deal wtih D as matter-of-factly as we can, as a part of our regular daily life. We eat what he eats and when he eats, we do what he needs to do, it’s just a part of life that has to be done. No drama.

  • We incent him to do a good job. He gets paid $$ when his day is good. He gets $5 for every flatline day, $3 for every day where he took all the right decisions (but it was impossible to flatline due to peaks), and $1 for every day where he did a good job but made easy-to-make (technical) mistakes.

  • We also have a rule at home, where he can eat anything he wants at any time IF HE DOSES. That includes, ice cream, cookies, whatever. But we also have many discussions about weight control as a PWD and other related subjects. We don’t want him to feel a need to binge in hiding.

How dow it work? So far, it has worked OK, although not perfectly. He does the best he can to control D, using all the techniques we figure out. Some techniques he is better at than others. He is not quite as skilled at stacking safely and as high as possible as we would like, but he does a very good job for a 13-year-old. Despite his uncontrollable daily peaks, his A1c is stil 5.5% right now (it started lower when he was not in puberty).

It is not perfect either. He does make eating decisions that are not always good. He is a kid, after all! He sometimes sneaks food that he thinks we would not want him to eat by dosing with a pen so we don’t know it (this way it does not show on his pump). I think this is very normal for a kid, and I am not worried. A couple of times, he has eaten something sweet without dosing. That stresses me out a lot. It is very rare.

We still determine the rails of his range (for us, 75-120, with a goal of 100), and, so far, he has not disagreed. We also do his night management. What will happen when these change? I don’t know. I hope it will be smooth, but, in my heart of heart, I feel it won’t be. So, right now, this is something that still is in the future and that I somewhat fear.

But not like I fear college. College is what I fear most. I have great hopes for newer technologies for closed-loop pumps, and I hope with fervor that, before college, he will be on one. Today, a 670G would not increase but decrease his control.

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I’m so incredibly impressed. You guys are awesome.

This is such a great way to think about it. Such a simple and easy to understand explanation for such a worrying topic.

I’m sure he’s more likely to listen for this reason.

What a lucky kid!!! You’ve given him all the tools he needs. Your love and the knowledge you’ve given him will probably help him breeze through college :wink: At least as well as any kid can, right?

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@Katers87, very interesting question. We have evolved our discipline as our kids have aged (Diabetes or not).

When small, we used timeouts
When 7-10 we took away stuff for minor infractions and grounded to room for major infractions
Once they hit about 11, we stopped disciplining in this way, except for video games issues. i.e. we would take the video games away when they ran over their video game allotted time, but wouldn’t take video games away for talking back to a parent for example.

We address discipline by having a conversation, for whatever reason (my wife is probably why) this works for us. My kids know we hold them to a high standard, and as they get older, we allow them to live and make small mistakes, and we are there to ensure they aren’t allowed to put themselves in a position to make life altering mistakes. The only place that I don’t feel we have control is the driving. It is easy to make mistakes driving, and it isn’t always in the drivers control.

For Diabetes, we were a bit lucky in that our son was almost 13 at diagnosis and so was already moving toward independent decision making.

Neither my wife or I consider diabetes behavior something we should incentivize or punish for. We review his status every couple of weeks, i.e. review pump and CGM data together and look for trends we can address. We might apply a little guilt here and there, but in the end, he has to manage this beast.

There is a standing offer to help in any way we can, waking him up at night, making calculation if desired (he doesn’t ask for this anymore), we offer to make all decisions for him for any period of time he wants, but he honestly feels like the Diabetes camp break is enough of a break for him. Probably the biggest thing we do is cook most meals from scratch and calculate the carbs for him.

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We incentivize as mentioned above. But we don’t punish. I think punishment for diabetes management would probably be the wrong tool for us.

We do withhold electronic privileges occasionally, or pile on chores, but for other issues, just not D.

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You guys sound so supportive. Sounds like such a healthy relationship.

I love this. We all learn from mistakes. Learning from mistakes is truly a skill in and of itself.

I really can’t communicate how impressed I am by the parents on this forum. Thank you for sharing :slight_smile:

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It’s the kids who are impressive: all of you who were diagnosed as kids and have had to live a childhood where navigating diabetes everyday was the norm.

Of course, as parents there is nothing we’d want more than take this on us rather than see our kids live through it, with us as spectators. It is emotionally difficult not to be able to help your kids.

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It’s probably bad, but I’ve wished to also get diabetes at times so that my son can see someone else getting stuck all the time.

In the end I just want Liam to have all the tools necessary to be a healthy strong adult in spite of diabetes. It sounds like most of us are the same where our children and diabetes are concerned:. Frank, supportive and encouraging.

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Well I wish I could take credit for this. By nature I am authoritarian and my wife is a soft trusting soul. Because we decided early on to parent together, and work out our differences before implementing our rules, we have landed in a good place.

It helped to have her confront me when I was too much of a disciplinarian when the kids were small, and point out that it wasn’t working so well. I also help her to always have a system in place, and not just trust and to understand that a little fear in the kids is helpful. Now they have a healthy fear of the repercussions that life and our society hands out when they stray too far from the path.

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Same here :slight_smile:

Interestingly, while we have had the worst of our arguments discussing how to raise our kids, we have never had arguments about D and our approach to it. We had that long discussion the first weekend after diagnosis, agreed on how to deal with it, and have never had to argue or readjust since.

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We are the same type of couple but I wish I could say we don’t argue about diabetes. Before diabetes we hardly ever argued but diabetes has brought about a whole new level of stress for both of us.

Each argument atleast serves to bring us closer to being on the same page. I believe arguments are healthy if you both want the same thing and only see getting there differently. My wife and I are both very opinionated so we sometimes butt heads on how best to accomplish something. The important thing to is isn’t the arguing, it’s the willingness to work through it together and figure it out as we go.

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That is certainly true for our everyday life for us.

Our arguments about diabetes are very focused: how high a correction, mostly. My husband is always readier to go higher. They are not significant arguments.

The big decision we had to make was how to approach diabetes in terms of life changes. We decided that we would deal with it as if it did not exist: we are expecting our boy to live a life that is unlimited by diabetes. Of course, this means a lot of work, because it is hard to make this come true.

This choice, btw, was a big part of why we decided to be a part of the wonderful group that started this site. We all believe in being unlimited here. This is not true anywhere else in the DOC (Diabetes Online Community).

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This is 100 pecent my wife and I.

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To me the disease was always self-motivating. I never needed any external motivation because it was always obvious to me that I felt much better when I had good BG than when I had bad BG.

My parents left the decisions up to me from a very young age. I started on 1 shot a day and after hearing and explanation from an endo (I don’t even know if they were actually called “endos” back then, I just called him “doctor” :slight_smile:), I decided later that 2 shots would be easier to manage and would give me better BG.

I simply told my dad one day that I wanted to try 2 shots (and then eventually I did 3, then 5, then 7, then 10… :slight_smile: )

My dad left it up to me. He made the right choice and so did I.

Bottom line, everyone feels better when their BG is well managed. That good feeling can be very motivating.

My parents never told me I was going to die if I didn’t do a good job, or that it would shorten my life, or anything like that. I don’t think that is a good thing to tell a young person. If they believe their adult life is at risk of not being as complete because of D, it can make kids live their “now” like they have no future, which is dangerous.

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This was not obvious to me when I was younger. Sometimes I think I was a lot more resilient when I was younger and the lows/highs didn’t affect me as much. There may be more than one reason for that, but I had no trouble learning/concentrating in high school. In college, I paid special attention to my blood sugar levels when I had exams because I noticed I wouldn’t do as well if I was outside of range. Maybe high school was just easier…maybe I just didn’t notice…maybe my range was wider in high school so I wasn’t as affected…

I don’t really know. I definitely feel the difference now though.

What type of insulin were you using, Eric?

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