The Adolescent-to-Adult Transition in Diabetes Care

There is something referred to as “the adolescent transition,” which is actually the transition to adulthood. “Emerging adulthood” is sometimes defined as ages 18-30.

(Being an adult is mandatory; acting like one is optional.)

The point is that as a teen with diabetes, you will at some point have to “grow up” in terms of your health care. You will communicate with health insurance (oh, and get health insurance coverage), make appointments, see adult health care providers, pay bills, and other fun things like those.

Research has shown a high number of hospital admissions for DKA in those who are transitioning to adult care. There is also a tendency for A1C to go up, office visits to go down, and rates of getting kidney function checked can go down as well.

When you become an adult you get to manage your diabetes on your own. You also get to manage all aspects of your health care. Get a strong handle on how diabetes works now, while you’re still at home. Ask your parents to teach you how to navigate health insurance. Start taking a lead at your appointments while you’re a teen-ager, so it won’t be scary or foreign when you are on your own.

Use your resources. College Diabetes Network is an organization that supports emerging adults with diabetes who are heading to and attending college. The Diabetes Online Community is chock-full of support and camaraderie. Another fabulous option is to get involved in a diabetes camp. And some endocrinology offices have providers who specialize in the transition to adult care, so be sure to ask if yours does.

Most important, stay on top of your diabetes care so that you will feel good, be productive, and live well now and far, far into the future.

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Show up and do diabetes

Or check BG. Or exercise. I’m sure you’ve heard of writer’s block. Kids in school, authors, bloggers – everyone experiences it at some point. Same with diabetes block. This stuff gets old and we sometimes hit a wall. But showing up and getting it done really does have benefits.

How many times have you gotten diabetes block? Making diabetes management a habit – committing to it and doing it over and over every day (even when we don’t feel like it) can help. Sometimes we get the results we want and sometimes we don’t, but if we keep showing up and doing the work, it will pay off, even in small ways.

It doesn’t matter what your spouse, friend, mother-in-law, health care provider thinks. Do it for yourself. Do it for your body, your strength, your long-term health and quality of life.

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Common Diabetes Questions

If you’ve read any of my blogs you know I’m passionate about the language (words) we use in diabetes care. I’ve mostly been focused on ways health care professionals can speak in order to empower people with diabetes, but it’s important for those of us with diabetes to be aware of the words we use too.

I recently came across a list of “Common Questions Asked by People with Diabetes.” The list contains 12 questions, and here is a breakdown of the words used in these questions:

  • Do I have to… (3)
  • Can I… (4)
  •  Should I…(4)
  • Do I need to… (1)

All 12 questions that people commonly ask health care providers about diabetes contain the words that people with diabetes don’t want to hear. Yet this is what we know and hear every day, so we perpetuate it, without even thinking about it.

Some other ways we can ask questions include

  • What (are the recommendations for…)
  • How (do I learn more about…)
  • Where (is more information about…)
  • Who (might help me with…)
  • When (does a support group meet…)
  • Why (might I be experiencing this…)

By asking questions that lead to empowering answers, we can actually empower health care providers at the same time! They won’t even know what hit them!

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Stop Doing What Isn’t Working

Some things are pretty simple and straightforward, yet we still don’t pay attention.

If something isn’t working, stop doing it. It may not seem that simple, but if we really look at every angle and use a little creative energy, it might actually be. There’s probably another way to do it, or at the very least another way to think about it.

Figure out what’s not working and change it. Even if that takes courage, or balls, or it’s really scary. Because the process of stopping what’s not working and changing it to something that does work provides hope. And it’s worth the effort.

Challenge yourself. Surprise yourself. Impress yourself.

You deserve it.

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Diabetes management is all about choices

It’s unlikely you have no choice. More likely: There’s no easy choice. When we say we have no choice, we feel trapped and we are powerless. That’s no way to do our work every day. – Seth Godin

This is so true with managing and living well with diabetes. We make choices every minute of every day. Diabetes affects everything and everything affects diabetes. But here’s the good news: we get to choose how we integrate diabetes into our lives!

We get to choose…

  • what we do
  • what we say
  • how we respond
  • our attitude
  • what meds we take
  • what we eat
  • what we drink
  • how we advocate for ourselves
  • what we share with others
  • the questions we ask
  • the information we seek

The first step is to accept that diabetes is about choices. They may not be easy – or inexpensive – but they are choices. Although we certainly didn’t choose to have diabetes, thinking of diabetes management as a series of choices puts us in charge. It gives us strength and power and helps us live well. I choose that!

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Diabetes No-Shame Day

Today is Diabetes Alert Day. Everyone knows someone with diabetes, but millions of people who have diabetes don’t know they have it. So the person you know with diabetes may not even know!

Unfortunately many people who are at risk for diabetes (or already have it and don’t know it) are reluctant to find out because

  • they are embarrassed
  • they are ashamed
  • they are afraid

It’s time to take the shame out of diabetes. If you have or are at risk for diabetes, it’s not your fault. There are many factors involved with developing diabetes, and most of them are not things you can change (like your genes, for example).

Fear is understandable – you may have heard scary things about people who have/had diabetes; you may worry about what changes are in store; you may fear that people will shame you.

My hope for the future of diabetes care is that professionals will put a stop to the shame that has gone with diabetes for so long. I also hope that with this bring a new mindset for the general public.

But in the meantime, don’t hurt yourself by staying uninformed. If your blood glucose is elevated there are things you can do to lower your risk of developing full-fledged type 2 diabetes, or at the very least delay its onset. And knowing your health status can prepare you to take better care of yourself going forward.

Please consider getting checked for diabetes if you have any of the risk factors. Encourage your family and friends to do the same. There is no shame in advocating for your health. You are worthy of a full, happy, and healthy life. Take the first step today!

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Understanding vs. Memorizing

It is more important to understand something than to do it by rote – or memorize it. Especially in diabetes management. If you find yourself doing something “just because” or “because they told me to,” ask about it. Find out why this works, rather than that. Find out so that you understand it – so that it makes sense to you. It’s your body, it’s your diabetes, and you deserve to know what, why and how.

  • Know the names of the medications you take, how much you take, how they work, and the possible side effects. Also know what other options exist.
  • Understand why exercise is important – how it works and how it makes a difference in your body.
  • Understand the effect food has on your body and your diabetes.

Don’t accept answers like “it just does” or “trust me.” Ask questions and demand answers.

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A1C frequency and glucose stability

This article says that people with type 2 diabetes may be having their A1C checked too often. They say that people whose blood glucose level is stable only need to get their A1C checked once or twice a year, yet many are getting it checked 3 or 4 times a year.

Right now Medicare covers quarterly A1C checks. The last thing we need is for that coverage to be taken away. I know that having my A1C checked keeps me in check. I am motivated to make sure that number comes out where I want it. When I go longer between A1Cs, I tend to slack off.

So let’s flip things around and ask this question: what if checking A1C more frequently actually contributes to healthier blood glucose levels?

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Prediabetes and Reducing Risk for Diabetes

At least 86 million Americans have prediabetes and most of them don’t know it. About 30% will go on to get diabetes. While diabetes is unavoidable for some people, it is possible for many people to reduce their risk for developing type 2 diabetes.

The Centers for Disease Control and diabetes health professionals discuss the importance of getting screened for prediabetes and knowing your risk for diabetes. If you do have prediabetes, there are steps you can take to potentially lower your risk for diabetes, such as being active and making healthy food choices.

Do you have prediabetes? Complete this prediabetes screening tool and find out today.

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Fear and Hope

Fear slows us down. Fear takes away our strength and our power. Fear is a negative, draining approach. Even writing about fear brings me down. Hope, on the other hand, lifts us up and gives us strength. Hope gives us energy to figure things out and do the best we can to live well. Hope helps us to focus on the positive.

The best part of all is that we get to choose. Although fear will creep in from time to time (often without warning or invitation), we can choose to overcome it and instead let hope guide us. I choose hope.

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