Studies Show How Adolescents Struggle to Control Diabetes

As if the adolescent experience is not traumatic enough, a number of teens must also carry the burden of diabetes through those difficult years.

Recently, both Diabetes Care and The Diabetes Educator featured research that has been done on the topic of young adults and diabetes.

The study that was published in the Jan./Feb. issue of The Diabetes Educator was originally conceived when two young adults from the diabetes support group and outpatient clinic at St. Vincent’s Hospital in Melbourne, Australia wanted to have something to which to compare their health-care practices with in order to see if they were “normal.”

The resulting questionnaire, written in part by the two youths in the support group with the help of Patricia L. Dunning, RN, M.Ed, FRCNA, included such questions as: How many blood glucose tests do you do each day? How many injections? Do you adjust your insulin doses, and, if so, why? Have you ever delayed an injection or sacrificed control to fit in socially? and, What is your greatest fear about diabetes?

Thirty-three males and twenty-six6 females responded to the survey. The males were aged 17-34, and the females were 19-26. Of these, 66 percent delayed or withheld insulin injections so that they would fit in socially, with 30 percent withholding or delaying on a weekly basis. The most frequent reasons that they did this were to eat more, sleep in, or drink alcohol.

Perhaps most frightening was the discovery that all but two of the 26 females had decreased their insulin doses to lose weight. Currently, two of the young women were still practicing this detrimental behavior. Only two out of the 33 males had ever done this.

Weight gain was listed as the second biggest long-term fear about having diabetes. The first was fearing a loss of independence.

It is interesting to note that the people who took part in this study did not list “maintaining good control to reduce complications” among the reason why 83 percent of them regularly adjusted their insulin doses.

The respondents were generally more afraid of high or low blood sugar because of how it made them feel. Thirteen percent of the respondents were afraid of severe hypoglycemia, and said that it affected their driving, sexual activity and work. They were also very afraid of having a severe hypoglycemic episode in public.

Even though they feared how being out of control made them feel, 12 percent of the young people “never” tested their blood glucose levels, and the majority of them tested their level only one time a day.

The group at Children’s National Medical Center and George Washington University that worked on the study that was published in Diabetes Care took their findings a step further, and took the parent’s and doctor’s perception of the level of management in the adolescents into consideration. While 25 percent of the youths in this study missed shots regularly, only 11 percent of parents and 10 percent of doctors thought this behavior was taking place.

Parents, however, thought that the young people were eating more inappropriate foods and faking more diabetes-related illnesses than they actually reported. Overall, though, the parents underestimated the frequency of mismanagement among the teens.

The study also found a significant number of patients who missed injections then took extra insulin to make up for it, and patients who fabricated blood glucose readings because the real ones were too high.

The majority of the people who missed shots were older and had higher HbA1c results. There was no significant differences in age or HbA1c for those people who missed tests. The patients that fabricated blood glucose readings did so mostly to please the people around them.

The results of the studies can be interpreted to show that young adults have a unique set of circumstances when it comes to managing diabetes during such a difficult time as adolescence – a combination that can lead to an unhealthy way of life.

According to the study, the fears and concerns of teens with diabetes are the same as everyone else with the disease, but their ways of dealing with them are different.

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