Like a fish on a fragile line, handling teenagers requires a delicate touch. My teenage son Danny has type 1 diabetes, and I’ve learned that when he overlooks important aspects of his self-care, it’s paramount not to let the lines of communication break. Sometimes calm restraint is the best option, as a recent incident demonstrates.

Two weeks before Danny turned thirteen, he and his friend Mike gathered up their coats and empty water bottles and followed me out the door of the indoor soccer arena to the car.

“Great game, guys,” I said.
“Thanks, Mom. Hey, do you think we could get slices of pizza on the way home?
“Sure, Dan.” Danny tends to have lows after exercise, so a slice of pizza in the car would help keep his numbers up. “Pizza is ten minutes from here, so you can test and bolus now. Remember, if your number is high because of adrenaline from the game, you only want to give yourself half the insulin the pump calls for.” I knew I had enough food in the car to cover the possibility that the pizza place was closed or that the slices weren’t ready. Mike added his two cents. “He already tested and he’s 211.”

We climbed into the car and I headed toward the parking lot exit. Suddenly, Dan spoke, his voice a bit lower. “I forgot to test at half-time, Mom.” Fear was my first reaction. Recently, I had been trying to give Danny more and more privacy in social situations. I hadn’t been traipsing around the indoor soccer field at half-time to remind him to test and waiting for his number. Now I realized that my decision meant he could have gone low on the field; he could have passed out. In the silence of the car, driving down the highway with two boys waiting for my reply, fear was replaced quickly with a rush of relief that he was telling me the truth. I knew that in front of his friend, I should keep it light. “Okay, thanks for letting me know.”

That night, after much reflection, I tucked Danny into bed.
“Hey Dan,” I said, “Let’s talk about the soccer game this afternoon. Why did you forget to test at half-time?” He was casual. “I don’t know. I sometimes just forget. It doesn’t really matter though, because I can feel when I’m low.”
“Well, you can usually feel your lows, but not when you are on an adrenaline rush headed for the goal. If you had been low at the half, you could have gone much lower during the second half and ended up wobbling or passing out during the game.”
“Oh. I didn’t think of that.”
“Well, you can’t really afford to have that happen again. How can we make sure it doesn’t?”
“I think you should remind me just in case.”
“When? Before the game or at half-time?”
“Both if you can. Just catch my eye at half-time to make sure, or if you can’t, will you come remind me?” I was amazed that he was choosing to go back to our old routine. “Okay,” I said, “It’s a deal.”

We don’t always get these moments with teenagers, but communicating at the right time can make a big difference. Pre-teens and teenagers are aching for more independence from their parents. As parents, we walk a fine line between giving them responsibility and making sure they are safe. I’ve found that to retain my son’s trust and keep our communication open, it sometimes requires a very light touch. Getting angry, using punishments, or making threats only encourage a child to keep his true numbers to himself. Keeping open communication and mutual trust as our primary goals can help us navigate the uncharted waters of the difficult teenage years.

Laura Plunkett is co-author of The Challenge of Childhood Diabetes: Family Strategies for Raising a Healthy Child. For additional parenting articles and helpful tips on improving nutrition and increasing exercise, go to the Challenge of Diabetes website.

View a video of Laura speaking at the UCSF Pediatric Diabetes Symposium on Diabetes Health TV.