Latest Catalogue Diabetes - Teenages

Diabetes - Teenages

DEFINITION

Diabetes or diabetes mellitus is a metabolic disorder characterised by hyperglycaemia (high blood glucose levels) caused by impairment in insulin secretion and/or action.


DESCRIPTION

Approximately 50% of people diagnosed with Type I diabetes are diagnosed before the age of 16 years.
Type II diabetes is usually diagnosed in people over 30 years, although it can occur in children and teenagers.

There are a number of issues that teenagers with diabetes may have to contend with, including:
- Feeling of being different from peers.
- Lack of spontaneity in their life and the corresponding need for a regimented lifestyle (e.g. insulin therapy).
Need for independence while still requiring parental support and supervision.
Embarrassment if a hypoglycaemic episode occurs.
- Fear of long-term effects and complications. See the Diabetes and Complications topic on the Healthpoint.
- Feeling of being continually supervised (e.g. by parents, physicians, nurses, siblings, teachers).
- Peer group pressure.
- Issues relating to drug and alcohol use.
- Concern that they may be a burden on family and friends.

ALCOHOL / SMOKING / DRUGS
Teenagers with diabetes need to be warned about the dangers of smoking, alcohol and drugs.
Smoking is an additional risk factor for the development and progression of retinopathy, nephropathy, neuropathy and vascular disease.
Alcohol consumption provides extra calories; initially increases blood glucose, plasma lipids and ketones levels and can result in delayed hypoglycaemia. Teenagers need to be advised that if they do drink, they should drink in moderation, drink low-alcohol beers or wine rather than fortified spirits or wines, measure blood glucose levels regularly, eat starchy foods while drinking and measure blood glucose before going to bed.
Drugs can decrease the ability/motivation of the individual to achieve glycaemic control, increase the risk of hypoglycaemia being ignored or misinterpreted, reduce/decrease appetite which can lead to hypoglycaemia/hyperglycaemia.

EXERCISE
Teenagers with diabetes, like all people, should be encouraged to exercise regularly. However, teenagers on insulin therapy need to consider the risks to themselves or others if a hypoglycaemic episode were to occur during physical activity. Activities that need to be approached with caution are those which are solo in nature, those that take place in a potentially hazardous environment (e.g. hang gliding or scuba diving) or limit a person's ability to recognise and treat a hypo (e.g. rock climbing, flying, abseiling, car/motorbike racing, cross-country skiing, swimming in open water or snorkelling). Teenagers are advised to avoid scuba diving and hang-gliding (except in tandem).

SCHOOL
In the school setting, allowances need to be made for teenagers with diabetes, for the following reasons:.
- They may need to drink or urinate more often than other teenagers.
- They may need to eat outside the scheduled school eating times.
- They may need to measure their blood glucose levels or take additional doses of insulin.
- They should be checked for signs of hypoglycaemia or insulin reaction.


TREATMENT OPTIONS

In no way is this information intended to replace the advice of a medical practitioner. Your Doctor will diagnose and help you to manage your diabetes. It is important to regularly liaise with your Doctor and diabetes management team to ensure good control of your diabetes. The team may include a Doctor, diabetes Educator, Dietitian, Podiatrist, Counsellor etc. The diabetes team is there to ensure that the teenager has a normal, healthy life with a minimum of complications. The teenager should gradually assume more responsibility for the management of the diabetes.


DIET HINTS

A Dietitian is an important member of the diabetes management team. See your Dietitian regularly to assist with meal planning to ensure that nutritional requirements are being met.
- For teenagers receiving insulin therapy, it is generally recommended that three main meals (breakfast, lunch, dinner) and three snacks (mid-morning, afternoon, supper or bedtime) be consumed over the day. This may vary according to individual insulin therapy regimes and growth factors.
- Growth should be monitored. If the teenager has gained excessive weight, fat intake should be reduced. Failure to gain weight may indicate a coexisting eating disorder, poor glycaemic control or an associated medical disorder.
- The amount and type of carbohydrate should be regulated to balance the hypoglycaemic effect of the insulin dosage. - - Carbohydrates with a low glycaemic index (e.g. milk, yoghurt, pasta, fruit, some wholegrain breads) are recommended.
A diet low in fat (particularly saturated fat) is recommended for teenagers.


ORGANISATIONS & SUPPORT GROUPS

See the Diabetes Australia topic on the Healthpoint.


PHARMACIST'S ADVICE

Ask your Pharmacist for advice.
1) Follow the Diet Hints.
2) Ask to be shown the range of diabetic products (e.g. blood glucose testing monitors available from your Pharmacy.
3) It is advisable for a person with diabetes to carry food to treat a hypo should it occur. Jellybeans or glucose tablets from your Pharmacy are good examples.
4) Keeping a written diary of test results is very important. A diary helps you and your Doctor to track your blood glucose levels over a period of time. This will indicate the effectiveness of the treatment schedule.
5) Ask your Pharmacist about the different types of diabetes identification bracelets or pendants which are available. Some type of identification should be worn at all times to alert medical staff in case of an emergency.