Guest: Sharon Schwarz - RN, MSN, CDE
Host: Dr. Linda Austin – Psychiatrist
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am talking now with Sharon Schwarz, who is a Diabetes Educator at the Children’s Hospital, Medical University of South Carolina. Sharon when teenagers have diabetes, I bet there are special challenges just as teenagers can make anything extra challenging. What are some of the issues that come up with the adolescent?
Dr. Sharon Schwarz: Teenagers definitely are a challenge, but they are wonderful. Our teenagers, we have to make sure that the parents are still involved even though they feel they are grown. We certainly want the parents to always be involved and we stressed that all throughout their school, age, process, and on into high school. They still need their school forms filled out and then you have driving issues. We have driving safety handouts for our teenagers, so that we make sure that they have checked their blood sugars before they drive and we always want their blood sugar to be at 100. We have medic alert bracelets and necklaces and IDs that go in their wallet and in their purse. That’s extremely important for our teenagers, who are driving that they have medic alert bracelet or necklaces and that they let other people around them to know they have diabetes. Even though, they don’t always want people to know that. But the people that are closest to them, it’s extremely important that they are aware that they have diabetes and how to help them should they have a low blood sugar.
Dr. Linda Austin: When teenagers become rebellious about managing their diabetes, what are some other ways that they act down?
Dr. Sharon Schwarz: Teenagers can sometimes want to know if they really do have diabetes and they may even quit taking their insulin shots. They may do different things with their insulin pumps and it’s very disturbing for the parents, but we try to reassure them even though that is very scary and we work with the child because we certainly don’t want them to act out in that way because it can hurt them, but we work with the parents and let them know that doesn’t make their teenager a bad child or a bad teenager. It’s their normal rebellion against the diabetes and we really again encourage counseling for all teenagers that have diabetes, so that they can learn to cope in a positive way.
Dr. Linda Austin: Adolescence is a time when kids are often very involved in athletics. What are the particular concerns that a parent might have in that situation or other concerns?
Dr. Sharon Schwarz: Certainly, there are concerns, but we always encourage our kids and our adolescence to be very active. The more active they are, typically the better blood sugar control, the higher their self-esteem, and all those wonderful things you get from being on a team sport or even an individual sport is still there. We certainly ask that they check their blood sugars before that activity and that they drink a lot of water. The biggest concern would be low blood sugar and that’s why we teach them to check their blood sugar right before that activity. During that activity, we give them special handouts and they have special education on how to manage their diabetes during that activity.
Dr. Linda Austin: The teenage years can be a very stressful time especially around test, exams, prom, graduation, arguments with parents, and those sorts of issues. Does stress make it more difficult for teenager to control their blood sugar level?
Dr. Sharon Schwarz: It certainly can and the hormones, just the hormone of puberty can change their blood sugars. Certainly, the stress hormones can increase blood sugars and again we work with the parents and we try to work with the adolescence and find positive coping skills, but a lot of that is phone calls to us and we are readjusting insulin over the phone during those growth years and those pubertal years. Certainly, the blood sugars do have a tendency to get more out of control just from true pubertal hormonal changes, but again we try to work with that making a lot of phone calls and having a lot of phone calls to make adjustments over the phone and working with the family. The family involvement is still very important even though they feel so independent.
Dr. Linda Austin: So, that must be an extra wrinkle then that at a time when kids are struggling, so hard to be independent, not be told what to do, yet, in this situation parent really has be extra involved.
Dr. Sharon Schwarz: They really do. I mean with the driving issues, the dating concerns, and certainly other social pressures and issues. We teach them how they need to be extra careful and even more responsible than your average teenagers to keep themselves happy and healthy and safe on the road and with their other friends. It is an extra stress, it certainly is.
Dr. Linda Austin: So, the drinking issues then that so many parents have with kids must have an extra spin when you are dealing with a diabetic kid.
Dr. Sharon Schwarz: It certainly does and we always ask the parents, who are very careful to make sure the parent is comfortable with us discussing that with them as well as other social issues that teenage girls can go through and boys too for that matter and we certainly want them to know the dangers that if you are faced with the situation that drinking in diabetes is very dangerous. It can cause low blood sugars and then the person that has been drinking may not even feel those symptoms. So, we teach the family that we really need to watch for that and to work with the child again in the dangerous of that and certainly our kids going off to college, we talk with them about the dangers of drinking in diabetes, driving, smoking, and all those social issues that they are going to be faced with.
Dr. Linda Austin: Sharon, thank you so much for talking with us today.
Dr. Sharon Schwarz: Thank you.
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