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August 4, 2000

Stress, Tight Control

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Question from Holyoke, Massachusetts, USA:

I am a 16 year old female and I have been living with diabetes for eight years. At first, I was doing really well with my diabetes and then, when I turned 12, my blood sugars stayed in the 200’s mg/dl (11.1s mmol/L). They would stay up no matter what I did. I just started to try to take three shots a day, and they put me on some pills. I am doing the best that I can for a 16 year old. The doctors don’t understand that we teenagers are under stress. When I am under stress, my blood sugar goes up and my doctors yell at me. What can I do to be in more control of my diabetes?

Answer:

From: DTeam Staff

You are to be congratulated as you sound very “in touch” with your diabetes. I also hear frustration in your message and hope the following helps.

When you experienced a raise in your blood sugars around 12 years of age, this was more than likely due to all the hormones produced around puberty. We see kids of this age needing double or more of their beginning insulin dose during these years. Another factor in raising blood sugar and insulin needs is stress, just as you have seen in your own diabetes management. Living through the teenage years is hard for most everyone and adding diabetes to that only adds to the challenges. If you are having wide swings in blood sugars and having to treat low blood sugars more than once a week, you might be feeling like you are on a roller coaster.

My first suggestion is to find a diabetes educator in your area who has experience working with people your age. He or she can support your challenges and may even have a teen support group as well. If you don’t know of anyone, you can call the American Association of Diabetes Educators at 1-800-TEAM UP 4.

Secondly, I would suggest you work with this educator to learn all you can about carbohydrate counting and matching rapid acting insulin to foods eaten as well as the correct amount of long acting background insulin to match your needs. Using an insulin pen or pump can also give you more flexibility and freedom as a busy teenager. The tools have improved over the years but are still not perfect. Good diabetes control is possible, but not perfect control. You are in charge of your diabetes destiny. Make use of the tools and people who can help you the most.

KS