Diabetic self-management is the number one factor in the effective treatment of this disease in the industrialised world. For adolescents with Type 1 Diabetes, the motivations to avoid feeling sick seem sufficient to promote self-management. For children, adolescents and adults with Type 2 Diabetes, the social effects of the disease or its causal factors can also inhibit effective self-management and healthy habits to manage the disease.
Normally, the first considerations for a diabetic are the medical concerns of regulating insulin and maintaining a healthy diet to prevent more serious life-threatening issues over time such as heart failure. However, particularly for those who acquired diabetes later in life, addressing the social and emotional effects of the disease can help a person succeed in self-care.
The most common social effect of diabetes is fear of potential or actual ridicule by peers. A young child whose parents and teachers are aware of her diabetic condition may face confusion and teasing from her peers when she visits nurse for a piece of candy to boost a low blood sugar moment. She's likely to hear "that's not fair" when only she gets the "treat" because fellow students don't understand it's necessary, not optional.
Discrimination and isolation are also real factors affecting diabetics. Adolescents with Type 2 diabetes tend to come from lower income or minority families and often struggle with obesity from poor eating habits. Peer ridicule or lack of social invitations may produce depression or social isolation, which in turn may undermine his desire to self-manage his diabetic care. Often not knowing other kids with diabetes can create a self-stigma that "I'm different than others."
A third common feature is choosing normalcy over self-care. Adults who eat out or drink alcohol frequently may find their temptations increase at a party or out with friends. Resisting the offers of party snacks or refusing to go out to eat can still incur jests or snide comments from peers who are unaware of the diabetic's condition so he goes along with everyone else and his self-care suffers.
Irritability, hiding food and binging as well as lying about blood sugar readings or food intake are common behaviours for diabetic adolescents who want to fit in with their peers. Resisting exercise because no one else in the family does it can be a hint that the diabetic is frustrated by the stress of managing her care without support. Depression is frequently associated with those who have diabetes and can interfere with self-management as well.
Family members with diabetes who are managing it well can be key role models for the newly diagnosed-diabetic. Meeting other peers with Type 2 diabetes through Diabetes Camp or support groups offers space to identify with those similar, rather than those different than you. Family and peer beliefs about food, eating habits and exercise patterns will either be significant helps to the diabetics' self-care or huge hurdles to overcome in managing the disease.
Continuing to provide general education about diabetes and its effects is a helpful community component that can support those living with diabetes. Remember that for families with one or more members who have diabetes, the whole family is affected and reshaping family habits will benefit all members. We must continue to strive for national awareness about the long and short-term medical, social and psychological effects of diabetes.