How do you help young adults (age 20) realize the importance of keeping their average blood sugar lower? My son’s A1c has been okay so he thinks he is doing fine, but on a daily basis, his blood sugars are over 200 mg/dl [11.1 mmol/L]. At this age, I am a nag. Do you have any suggestions?

I have a young adult diabetes clinic and this is one of the most common issues we discuss. It seems that there will always be kids who are just tired of dealing with their diabetes and do not see beyond the immediate scenario. I find this comes with maturity. We would all like for that to come sooner rather than later. Sometimes, pointing out the loss of health and the consequences this brings is not enough to faze my patients. For young women, I can often appeal to their desire for a family in the next few years and the importance of having good blood sugars now to help with that. For guys, it is often more difficult. One of the benefits of having good blood sugars is the control that comes with it. No surprises. No negative impact on job, school, or social life. If the blood sugars can be improved enough, there is the benefit of feeling better. This sometimes equates to better athletic performance or exercise tolerance. There might be a concern about hypoglycemia or avoiding hypoglycemia. If that is the case, it is sometimes good to air out those concerns in order to try and prevent them. Finally, I have some of our kids who look at me and say they are not ready to made the sacrifices necessary to allow for better blood sugar control. They feel the monitoring and the bother is more than they want to do. For those kids I feel the most sorry, because it is very often closer than they think possible.

JTL