Many college-bound freshmen have the same questions about their new roommate: Will she be messy, drink a lot, have a weird boyfriend? Caroline McEnery, who heads to Boston College this month, has a few extra concerns, such as: Will her roommate mind bunking with someone with diabetes?
"Some people are uncomfortable with seeing someone stick their finger," McEnery says. She has type 1 diabetes -- a condition in which her pancreas does not make enough insulin, a hormone that helps the body use glucose for energy. She pricks her finger numerous times a day to obtain a drop of blood to test her blood sugar.
The 18-year-old from Fairfield, Conn., manages her condition on her own and has not allowed diabetes to stop her from achieving her goals, she says, including playing on her high school volleyball team, skiing every winter, traveling to Ireland or going away to college to study nursing. But she says being a teenager with type 1 diabetes has had its challenges, such as meeting new people and explaining her condition.
Already a tough phase of life
"Even though it is a part of me, I don't want diabetes to define me, and I don't want to make anyone uncomfortable," says McEnery, who found out she had diabetes when she was 9.
Teenagers with type 1 diabetes have unique needs because they are going through hormonal, emotional and social changes that can have a huge influence on their blood sugar, says Steven Willi, director of the Diabetes Center for Children at the Children's Hospital of Philadelphia. They are also making more of their own food decisions and eating more because they are growing, so they may need to check their blood sugar more often than they did as a child, Willi says.
According to the American Diabetes Association, one out of every 300 children have type 1 diabetes. Type 1 diabetes accounts for about 10% of all diabetes cases, and about 1.4 million people in the USA have the disease.
Willi says that if a young person with type 1 diabetes stays well controlled -- checks blood sugar regularly, tracks carbohydrates and takes the right amount of insulin to help metabolize the glucose in carb-rich foods -- then that person can do anything he or she wants to do.
The biggest problems for a teen are keeping blood sugar from dipping too low or climbing too high, says Alexandra Salazar, a registered dietitian who specializes in pediatric diabetes at the Children's Hospital at Montefiore in New York City.
Hypoglycemia (low blood sugar) causes dizziness and energy loss. Less commonly, a person can pass out from extremely low blood sugar, go into seizures or a coma, or die. "With teens, hypoglycemia can happen if you exercise too much without eating, if you skip a meal, or at night while sleeping," Salazar says.
A young spokesman for diabetes
Nick Jonas, one of three brothers in the pop band the Jonas Brothers, says that while he is on the road or performing on stage, the family's staff stows plenty of juice, water and snacks nearby to help him keep his energy up. "I also drink tons of water to stay hydrated," says Jonas, who has released a song, A Little Bit Longer, about having diabetes.
Long-term problems, such as blindness, kidney disease and nerve damage, occur when a type 1 diabetic has prolonged hyperglycemia. That can result from regularly eating carb-heavy meals such as fast-food hamburgers and consuming sugar-packed drinks and not taking enough insulin to help metabolize those foods, Salazar says. "I've had some young kids who were always well-regulated when they were 6, 7, but then in adolescence sometimes all of a sudden they are not in good control. It has a lot to do with the whole social aspect. They don't want to be different. They just want to eat what other kids eat." She says teens also play more sports in high school, and many don't realize that exercise lowers blood sugar and that they need to eat more to compensate.
Having a supportive circle of family and friends, even teachers, can make life easier, says KayLyn Morrissey, a family nurse practitioner in the endocrinology department at Duke Medical Center in Durham, N.C.
McEnery's friends and family know the signs of low blood sugar and how to help if she feels unwell. "I'll get shaky and have no energy, and a friend will run and grab me a juice," she says.
Morrissey says a child should be given control of disease management as she gets older. By high school, a teen should be doing most of the monitoring and dosing herself, says Morrissey, whose daughter, Sarah, now 17, was diagnosed with type 1 diabetes at age 8.
"I taught Sarah at 8 how to use a glucose monitor and, more importantly, that she needed to know her body, not just judge her condition by her glucose numbers, but to be aware if something did not feel right," Morrissey says.
Says Nick Jonas: "My mom's still involved, but for the most part I've become a pro at knowing how many carbs are in something and how much insulin to take." He says he intends to keep singing with his brothers and helping other children with type 1 diabetes feel less alone.
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