Teen Girl with Type 1 and Food Choices

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Spirit replied on Fri, Nov 13 2009 7:20 PM

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Jean:  I don't have an answer for you, but I do think that you are on the right track looking for a support group for T1 girls. The adolescent years are unique in that they are geared more toward peers than adults.  Speaking as a parent of a 22 year old, this, too, shall pass.  But it can be a tough phase to go through at the time.  Tough for you AND tough for her! Can her therapist suggest a support group (diabetic or not)?  Or be willing to start one? How about her school?  Can you approach the school nurse?

Spirit

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jeannewiley replied on Sat, Nov 14 2009 11:07 AM

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Spirit: Thank you for responding to me. After I posted my message, I spoke with our Social Worker at Children's Hospital who said that this is a group of children that have been under-addressed. She gave me the name of a clinic in Newton, MA -- however, this clinic only deal with T1s over 18. The eating disorder clinic @ Children's (which my daughter attended pre-T1) doesn't work with T1 kids. I have briefed her therapist and the school nurse, on her own, contacted our Diabetic Nurse Practitioner. So I'm not alone --- unfortunately, my daughter is -- being in denial. She has many T1 guy friends and no T1 girlfriends.

I'll see what our Nurse Practitioner has to say on Monday.

And probably stupidly, I resorted to grounding my daughter after she decided to have cookies for breakfast (yesterday after she didn't feel well enough to go to schoo)l and not an egg and toast. I am grounding her until she starts keeping a journal. So now we're punishing her for being diabetic!

did you child struggle with eating and body image problems? If so, how did you handle it? How did she handle it?

Jeanne

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jen1229 replied on Sat, Nov 14 2009 11:35 AM

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Hi Jeanne:

I don't have children and I am not a therapist, just a diabetic like the rest of us.  But I have some thoughts about your post.

Can you sit down with your daughter and tell her you want to have a frank discussion.  That you are not punishing her for being diabetic, but for not taking the responsibility of the adult she says she is and doing what is right.  There are many people with chronic diseases they learn to deal with them.  That until she can act like an adult in regard to her diabetes care, then you will take charge of it.  You ill do all injections and all meals will be eaten at home, prepared by you and all carbs counted by you.  If she wants to take charge of her disease, then you are willing to give it one more chance.  If she doesn't live up to the bargain then you have to be prepared to do it.  It would mean having all meals at home (or lunch for school prepared by you and school nurse to do her injections and testing). 

I don't think she would want that so maybe she would be willing to make a contract with you for a month or two or three, whatever you both decide and if things improve fine, if not, then the more drastic steps are taken. 

Also, I think you said she is fifteen.  She is going to want to drive, and you need to make it clear to her that she will not be allowed to get her license if her disease is out of control, because it could result in an accident or worse. 

As I said I don't have children, so I'm not speaking from experience, but having been pulled over by a cop once when BS was low and having to wait on the side of the road for the EMTs or they would not let me go, it was not a pleasant experience, and I was downright scared (and I was not a teenager) and I was less than a quarter mile from the restaurant where I was planning to stop and eat.

Don't know if this would be of any use to you,, just thinking out loud, so to speak.

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jeannewiley replied on Sat, Nov 14 2009 11:45 AM

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Jen:

This is hugely helpful. I think I will print this when I sit down with her.

She is not allowed to even do drivers ed until she gets her levels under control. She doesn't care about that yet.

But your voice is really helpful. If a fellow diabetic finds her behavior lacking, then it's not just Mom (or someone who doesn't have T1 and therefore can't understand) being unreasonable.

Thank you so much!

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Spirit replied on Sat, Nov 14 2009 5:48 PM

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Jeanne:  My daughter was not diabetic nor did she have eating issues.  Just the usual teenage angst stuff, which colors everything in the most dramatic way possible!  Jen's suggestions are good ones.  A contract clearly spelling out who does what but leaves room for changes as needed and re-negotiation can be very helpful with teens.  They really are caught between two worlds, that of childhood and that of adulthood.  Each has an appeal and a pull.  Add to that the hormonal changes that take them as much by surprise as everyone around them and you have a young person who wants to cuddle with her stuffed animals one minute and be the hottest chick on the block the next.  And teenage girls, even the steadiest of them, tend to turn into Drama Queens.  So, the clearer the expectations, the clearer the tasks allotted to each of you and the clearer the consequences, the better.  One thing that I do think you need to be sensitive to is your role with her is changing.  There may be times when she wants (and perhaps needs) you to be the "Mommy" of her youth and other times she wants you to back off altogether.  As a diabetic, she must ultimately take ownership of her disease herself.  You cannot monitor her every food morsel so she must accept the responsibility for healthy eating.  She will also be under pressure from her peers to eat with them in a companionship way.  Much of teen life revolves around hamburger and pizza joints and food courts at the mall.  She needs to have the tools in her personal arsenal to deal with this in a healthy way and what she can say yes to and what she can't. 

Spirit

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jeannewiley replied on Sat, Nov 14 2009 7:06 PM

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You're absolutely right. The negotiations have begun. She began writing down her food intake today and we allowed her to go out with her friends. We will need to see if her glucose levels mirror her log. We had a bad week of 42, 37 and 470 plus two days of school missed.

Ultimately, I just wish she was happier and more motivated.

Jeanne

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T1gal replied on Sat, Nov 14 2009 9:11 PM

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Hi Jeanne, I just wanted to add something here.  Please make sure you are holding her accountable for her actions, NOT the results as reflected in her blood sugars.  There are aspects of T1 that we can control, and aspects that we cannot, and that is frustrating enough as it is.  Learning to treat the numbers as "just information" is so critical in the emotional aspects of living with Type 1.  The teen years are difficult in terms of hormonal fluctuations, growth, etc. that can impact blood glucose.  Even as an adult with T1, I would hate the thought of someone judging the efforts that I put into my care on a given day by my blood sugar readings.  Sometimes we can do the exact same things, and get very different results.  My heart goes out to you and your daughter.  

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Spirit replied on Sun, Nov 15 2009 9:26 PM

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T1gal makes an excellent point.  Readings can be truly unpredictable at times, despite our most concerted efforts.  A surge of growth hormones, menstrual periods, stress (which is almost constant in an adolescent's life!), poor sleep and even the slighest case of physical unwellness (sniffles, even minor infections) can have an immediate and major impact on glucose readings.  But if you and your daughter are honest partners in this compact to deal with her disease, you can figure out the reasons together.  And the more she does that investigative thing with your support, the less they will take her by surprise.  There have been plenty of times when I knew that the reason for my higher readigs was ____ (fill in the blanks).  I couldn't go back in time to change them, but it taught me one of two things:  1). try to avoid the problem in the future by eating more/less or excersing more (I am not taking insulin, so I can't add that to the probelm-solving mix) or 2) chalk it up to the oddities of diabetes and just the whole thing go.  Sometimes #2 is the only solution.  If nothing else, diabetes teaches us patience and acceptance. And when you are living with an adolescent, diabetic or not, those are GREAT things to master!

Spirit 

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jeannewiley replied on Mon, Nov 16 2009 7:46 AM

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You both make terrific points and my daughter and I have been discussing them this weekend.

Today we meet with our Diabetic Nurse and will continue the dialogue.

I still feel that a teen group for girls would be invaluable!

Thank you all for your amazing input!!

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Debbie Butler replied on Mon, Nov 16 2009 1:51 PM

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I do not know of any groups for teenage girls with diabetes that focus on their relationship with food.  It sounds like you are very worried about your daughter.  Have you discussed these concerns with your daughter’s diabetes health care team and her therapist? I know you said that she meets with a counselor that specializes in eating disorders but I also wonder if you two would consider meeting with a counselor that is knowledgeable about diabetes?  Sometimes people with diabetes do not like to tell other people what they have eaten because they feel that they will get in trouble, so a counselor may be able to figure out what has been difficult for your daughter since she has been diagnosed with diabetes and help figure out ways to help.  You also may want to meet with a nutritionist that is knowledgeable in both diabetes and eating disorders.  Good luck!

-Debbie Butler, MSW, CDE

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Debbie Butler replied on Mon, Nov 16 2009 2:02 PM

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I made the last posting before I had read through the string of e-mails, so I apologize.  It looks like you have spoken to her diabetes health care team at Children's Hospital which is great.

I also wanted to comment on some of the other postings.  I agree with the person that said that we should try to reward the behavior vs the outcome.  For example I think it is important to reward the act of blood sugar checking vs what the actual blood sugar reading is.  I also agree with the comment that all blood sugar information is good information vs looking at blood sugar number as "good" if the blood sugar is in range and "bad" if the blood sugar is out of range.  If a child or teen feels like they are going to get in trouble for a blood sugar result then they may not tell you the accurate value and just tell you a number that you want to hear, and then you can not make a correction.

Also if possible I usually recommend that parents should try not to punish their child for diabetes tasks but reward them for things that are going well. I find that can be more motivating.

Again, I am glad you are working so closely with your daughter's health care team.

-Debbie Butler, MSW, CDE

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jeannewiley replied on Mon, Nov 16 2009 3:55 PM

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We just met with my daugther's team and they think she's doing a good job - just eating like a kid. I was given permission to not worry about her food choices, because she would be making the same choices if she didn't have diabetes. I'm allowed to nag her - as the mother of a teen - but not as a mother of a diabetic teen. I told my daughter about my fears and she seemed to understood.

So all is well.

The team said that T1 teen girls don't want to get together to discuss their disease - they rather get together and discuss boys, clothes, etc.

My daughter also informed us that there is a new slang for teen girls with diabetes: diva-betes. So I guess it's cool to be a T1 teen girl.

Thanks everyone for your help and for your kindness!

Jeanne

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Spirit replied on Mon, Nov 16 2009 4:51 PM

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"Diva-betes"!!  That's great.  I Love it. 

Spirit