Teen diabetics give it their best shot

Think being a teenager is difficult? Try being a teen or tween with Type 1 diabetes.

Roughly 2.3 million Americans live with Type 1 diabetes, a chronic disease in which the pancreas, the organ that secretes insulin, is destroyed by auto-antibodies. That's why people with Type 1 diabetes always need insulin, either injected or delivered through an insulin pump.

Most people with Type 1 diabetes are diagnosed as children, and as they grow up, they must learn to navigate all the usual adolescent traumas, including dating and hormonal changes, while at the same time taking over management of their blood sugar levels. That includes eating a healthful diet throughout the day.

Experts say although all diabetics face challenges, there are some issues specific to teens, such as:

Hormones. Puberty's physical and hormonal changes can trigger unexplained blood glucose spikes and drops, meaning there's potential for constant changes to medical treatment, says the American Diabetes Association. Also, moodiness that is a normal part of puberty can be mistaken for hypoglycemia, or low blood sugar.

Driving. The Juvenile Diabetes Research Foundation International says driving with low blood sugar can be similar to drunk driving, making it critical that teen diabetics know how to compensate. They must check their blood sugar regularly, carry snacks in the car and make sure others in the car know about the their condition.

Eating disorders. Adolescent girls with Type 1 diabetes are twice as likely to have eating disorders as peers without diabetes, according to a 2002 study in the medical journal Diabetes Spectrum. The disorder, called diabulimia, occurs when young women deliberately skip insulin injections to control or lose weight.

Most teens manage just fine. They take on the responsibility of checking blood sugar at least four times a day, injecting appropriate amounts of insulin, and adjusting their diet to feel well.

But there are frustrations.

"I get kind of mad because I see that I'm not the same as everyone else," says Janae Burnett, a New Port Richey, Fla., 11-year-old who was diagnosed with Type 1 diabetes six years ago. I can't eat this or that. I can eat certain things, and I have to stop at a certain amount."

That feeling of being alone is not uncommon, according to a 2008 survey of more than 6,000 children with diabetes, and their parents and health care providers. One in six youths surveyed felt they had no one to turn to at school in case of a diabetes-related emergency, says the DAWN Youth Survey, sponsored in part by diabetic drug and supply maker Novo Nordisk.

Leaving class to get an insulin shot or to check blood sugar levels is another thing that can set kids apart, although different schools have different policies.

"I'm in a private school, so I'm allowed to check in class," says Maya Jacobson, a 13-year-old Clearwater, Fla., teen diagnosed with Type 1 a year ago. "And my friends actually think it's pretty cool and neat."

Misconceptions about the different types of diabetes are another challenging part of living with the disease, some teens with Type 1 say. Many people confuse what they have with Type 2 diabetes, which is far more common and can be managed and even cured with medication, diet and exercise.

Because Type 2 diabetes is often connected to being overweight or leading a sedentary lifestyle, teens who have Type 1 often hear that they just need to get moving and lose a few pounds to get better. The truth is that kids with Type 1 are usually thin. And they will need insulin for the rest of their lives.

"They're mistaking it for obesity," Burnett says. "People think I'm not fat, so I shouldn't have diabetes. I explain it to them."