Day-to-Day Care

The pre-teen and teen years are characterized by changes in hormonal levels, nutritional needs, and peer and family relationships. Body image becomes tremendously important, with some teens viewing diabetes as a defect that needs to be kept hidden. They can become preoccupied with food and weight issues.

Boys tend to be growing non-stop, and need to take in more calories than ever to keep up. They may feel as if they can eat anything without their blood sugar getting out of line. Unfortunately, this can lead to problems after puberty, when growth slows and they have to learn new, more disciplined habits.

For girls, the changing hormone levels related to puberty tend to require greater amounts of insulin. Then, after the first menstrual period, their growth slows and food and insulin needs diminish. Girls may put on weight more easily, even as they cut back on calories. This can be frustrating for body-conscious girls who often realize that by skipping insulin injections, they can drop weight quickly. This can lead to eating disorders and increased risk of ketoacidosis. What's more, as soon as they bring their blood sugar back into range, the weight comes back on. If your daughter wants to lose weight, make sure she understands that she has to do it under the supervision of her doctor.

Healthy Meals & Snacks

Whether your teen has type 1 or type type 2 diabetes, their meal plan will likely come to the forefront during these years. Kids this age don't like to be on a schedule - they want to go for pizza or a burger whenever their friends do. And social events and sleepovers often revolve around food.

•  At home, have everyone eat the same menu. A healthy meal plan is right for the whole family, and won't make the person with diabetes feel singled out.

•  Keeping mealtimes cheerful will help instill in your teen the idea that food isn't the "enemy." It's to be enjoyed.

•  Strike the word "cheating" from your vocabulary and teach your teen that any food can be a part of his or her diet, as long as they plan for it by choosing other foods, increasing exercise, or altering medication according to the doctor's recommendation. This can keep your son or daughter from feeling deprived, and the temptation of the forbidden won't exist.

•  Understand that while insulin may be used to cover various food choices, using extra insulin on a regular basis can result in weight gain.

•  As your teen makes his or her own food choices, they may slip up from time to time. Encourage them to be honest with you and praise them for it. Getting in trouble for eating the wrong foods will only encourage them to bend the truth next time.

•  Keep a close eye on your daughter for signs of an eating disorder. Diabetes doesn't increase her risk of having an eating disorder, but the combination can be very dangerous.

Ongoing Activity

Whether your teen has type 1 or type 2 diabetes, exercise is an excellent way of maintaining a healthy body weight and controlling blood sugar. Many kids this age are enthusiastic participants in a wide range of activities. Others need a little more encouragement. But your teenager doesn't have to become a track star to enjoy the benefits of exercise - any physical activity such as walking the dog, riding a bike, swimming, or dancing counts. However, if you can get them to join in, playing sports is a great way for people to build confidence, make friends, and exercise on a regular basis.

•  Your doctor will give you an idea of how often your son or daughter should be exercising each week.

•  Make sure your teen's teachers and coaches know that your teen has diabetes, and what to expect. Read more about this in our Away from Home section.

•  Have your son or daughter test blood sugar before and after exercise, as well as during activity if it lasts for more than an hour.

•  If blood sugar is high, it's time to check for ketones in urine. If ketones are moderate or high, exercise should be postponed until later.

•  If an injection is needed prior to activity, choose a site that won't be exercised.

•  Help your teen get in the habit of checking their shoes before exercising, and inspecting their feet afterwards. Rough spots in shoes can cause trouble, and any blisters, sores, or pain that doesn't heal quickly should be reported to the doctor.

•  Make sure your son or daughter always wears a medical ID bracelet or tag, in case of emergency.

Blood Sugar Monitoring

Over time, people with diabetes are usually able to identify the feelings associated with low blood sugar. Still, blood sugar can be unpredictable. You can do everything your doctor recommends and the test results can still come as a surprise. So frequent monitoring is as important as always. Here's how to take out some of the sting.

•  Make sure that your teen understands that the goal of monitoring, as well as other self-care efforts, is to regulate their blood sugar so they can ultimately feel good.

•  Explain that blood sugar monitoring isn't optional. Some people believe that they know their blood sugar level by the way they feel, but the tests often prove otherwise.

•  Check your teen's self-monitoring log regularly. Missing information can be a tip that tests or injections are being skipped, or that out-of-range results aren't being recorded. Assure your teen that the goal of logging is to learn -- they aren't being graded on the results.

•  Understand that a bad hair day, a zit, an exam, or even a new crush can send blood sugars up or down, in spite of your son or daughter doing everything they should. Stress is the wild card in blood sugar control, and teenagers seem to have more than their fair share of it.

Insulin Injections

People with type 1 diabetes need insulin injections every day - often several times a day - as do some people with type 2 diabetes. As an alternative, consider an insulin pump which may offer more consistent blood sugar control. Pumps have been found effective even for kids under 13.

If you're relying on injections, remember to rotate sites regularly. Ideally, you don't want to inject into the same site more than once every 30 days. Naturally, people prefer certain sites, because they hurt less. But using a site too much will cause a fatty deposit to develop and a lump will form.