Communicating with teens with type 1 diabetes

Sarah Jerstad, LP PhD and Chelsea Weinstein, LICSW

Successful communication is a key ingredient to helping families successfully manage diabetes. Research shows that parent child conflict is associated with poor diabetes control while effective family communication and negotiating skills are associated with achieving good diabetes control. This is especially true to families with teenagers who have type 1 diabetes. Often diabetes and discussions around managing it can be a tricky subject for parents to broach with their teens due to those discussions being unintentionally problem focused or negative and critical rather than being positive and supportive.

If this sounds familiar or you are struggling with your teen, the following are some general suggestions to help improve communication and problem solving:

• Use I statements, avoid starting conversations with blaming “you” statements such as, “you never do what I say”. Instead of putting your teen on the defensive, using an “I” statement avoids blame and keeps communication open rather than shutting it down. Examples would be “I’m worried about your health when you don’t take your insulin” or “I’m upset that you skipped your diabetes appointment”.

• Schedule regular family meetings to check in about how things are going with diabetes management and to discuss on-going issues. Schedule these at a time that works for everyone and keep agenda’s open to discuss everyone’s concerns.

• Since you have meetings scheduled, try to focus on other aspects of their life before bringing up diabetes. Ask how school was and discuss other topics before getting right to diabetes. This communicates that as a parent you care about all aspects of their life, not just their diabetes

• If BG is high after school: instead of  “why is your BG like that, what did you eat?, Didn’t you take your insulin?” help teen determine cares in moment: “what cares do we need to do now to help bring your BG down, let’s consider when you last took insulin and determine if it’s time to take insulin now?”. This will show you are problem solving with them and not looking to blame.

• Set goals with your teen, rather than for your teen.

• Avoid using “good” or “bad” to describe blood glucose levels, rather focus on the value of accurately checking blood sugars and responding appropriately.

Remember, communication is a skill and it can be improved. Effective communication is essential to help your child manage diabetes, even more so in the adolescent years. Resources are available including family to family mentoring, social work, diabetes support groups, and psychological services in the endocrine clinic if you feel your family needs additional support navigating communication.