Noticing Risk Behaviors

Chelsea Weinstein, MSW, LICSW, Gina Davis, MSW, LICSW, Sarah Jerstad,  Ph.D., L.P.

The teenage years are a time when adolescents are experiencing a significant amount of physiological changes and exploring an increased sense of independence. Though it is natural for teens to explore and test boundaries, sometimes teens feel they are “invincible.” This feeling can make teens more likely to take risks and experiment, with potentially harmful consequences. Having a chronic illness like diabetes adds extra risk to these behaviors and the negative consequences for their health may be even worse. Some risk behaviors that are particularly important to pay attention to during this time include unsafe driving habits, concerns about body image/eating disorders, and the use of drugs or alcohol.


Learning to drive is often an exciting time for teens. In addition to the standard rules of the road teens with diabetes need to be practicing safe management habits to protect themselves and the others around them. Teens should be regularly checking blood glucose levels before driving and bringing needed supplies (meter, insulin, needles, snacks etc) with them in the car. Forgetting to do this can put everyone at risk. Driving with a low blood sugar can result in greater impairment than driving when intoxicated! Here are some ways to help keep your teen safe in the car:

  • Discuss and agree on rules around driving ahead of time
  • Keep snacks available in the car
  • Have open communication about plans
  • Check blood sugars prior to driving
  • Always take insulin
  • Keep diabetes supplies easily available
  • Wear medical identification
  • For trips longer than 1-2 hours, be sure to bring insulin with you

Eating Disorders

Although the prevalence of an eating disorder is relatively low, disordered eating behaviors among teens, such as restricting food intake, self-induced vomiting, or taking diet pills, is unfortunately more common. These behaviors are more common in girls, and teenage girls with type 1 diabetes twice as likely to develop an eating disorder compared to girls without diabetes. One concerning behavior to watch for is the omission or reduction of insulin for the purpose of losing weight. Over time, that behavior places the individual at risk for complications associated with chronic high blood sugar. Your teens might believe that using insulin will make them gain weight and is part of natural metabolism. It is important to remind them that using the appropriate amount of insulin for food consumption and correction will not cause weight gain. Here are some ways to set up a right environment to promote healthy living and prevent eating disorders and disordered eating behaviors:

  • Model healthy attitudes toward food and eating
  • Be mindful of how you talk about food – no food is all good or bad. It’s about eating a balanced variety
  • Promote a body positive perspective by discouraging the idea that a particular body shape or weight will lead to happiness
  • Have discussions that challenge the messages that media sends about the unrealistic body ideals

Drugs and Alcohol

Though consumption of alcohol is illegal to those under 21 and the use of recreational drugs is completely illegal, experimentation with these substances tends to occur during adolescence and poses a variety of risk for teens with diabetes. Teens should know that drugs and alcohol can change the way they think and act.  Someone with type 1 diabetes is at higher risk of having low blood sugars for up to twenty-four hours after alcohol consumption. In addition to the well known dangers associated with recreational drug use, people with diabetes should be aware of a few diabetes specific risks. Marijuana use can cause tiredness, food cravings, interruption in the diabetes routine, and inability recognize how to treat low blood sugars. Opiate use can interfere with concentration and coordination, and uppers can alter perception and sleeping routine.

If you are of legal age here are ways to use alcohol safely:

  • Drink alcohol in moderation (two drink limit is a smart rule)
  • Don’t drink within 2 hours of exercise
  • Check blood sugars often
  • Eat 15 grams of carbohydrates uncovered for each alcoholic beverage
  • Wear medical ID, select a safe place, and have people around who know about diabetes
  • Do not experiment alone
  • Check blood sugars before bed and set an alarm to get up in the morning
  • Ask someone to check on you in the morning
  • Always take your insulin

There is so much change happening during the teen years, and teens with diabetes are managing additional stressors and risks. With patience, support, and supervision however, this can also be a very positive time for teens as they gain independence and develop their self identity and learn to care for their diabetes. If you have any concerns about your teen and risk factors related to diabetes, please contact us at the clinic for additional support and resources. We can be reached at 651-220-6624.