Type 2 Diabetes Mellitus (T2DM) is the most common form of Diabetes. The prevalence is increasing world wide, sadly nowadays it is developing in teenagers too. Type 2 diabetes mellitus especially in those with poorly controlled blood sugars may lead to heart attack, stroke and other complications. People with type 2 diabetes mellitus end with several health complications. If people develop DM at an early age, the quality of life decreases and they will develop complications soon. Here are some of the common problems faced by Teenagers with Type 2 Diabetes Mellitus (TWT2DM):

• Teenagers with Type 2 Diabetes Mellitus (TWT2DM) face a unique set of challenges, which I will explain later in this blog.
• They experience several physical and psychological changes during their adolescence period.
• An adolescent with T2DM feels isolated compared to their colleagues, which can result in feelings of loneliness, low self-esteem, anxiety, body image distortion and depression.
  
  

What are the symptoms and warning signs of T2DM?

Signs and symptoms of type 2 diabetes:

• Feeling very thirsty 
• Extreme fatigue 
• Irritability 
• Blurry vision 
• Itching 
• Longer time for wound healing 
• Frequent urination
• Numbness, tingling, or discomfort in the hands and feet
• Weight loss or weight gain
• Impotence or erectile dysfunction
• Repeated infections in the genital areas, urinary tract, skin and oral cavity.
  
  

What are the risk factors of T2DM?

Risk factors that can increase the chances of developing type 2 diabetes:

• Genetic predisposition: Risk is higher if there is a history of diabetes in the family particularly between parents or siblings. 
  
  
• Age: The risk rises with age, generally beyond the age of 45.
  
  
• Obesity: Being obese or overweight is a serious risk factor.
  
  
• Physical inactivity: Lack of physical exercise and sedentary lifestyle increases the risk. 
  
  
• Unhealthy diet: Risk factors include diets high in processed foods, sugary beverages and deficient in fruits and vegetables. 
  
  
• High blood pressure: Hypertension can increase the risk of type 2 DM. 
  
  
• Abnormal cholesterol levels: High triglycerides and low HDL cholesterol levels can be risk factors. 
  
  
• Gestational diabetes: The risk is increased in pregnancy with gestational diabetes.
  
  
• Polycystic ovary disorder: Women who have PCOD are more likely to develop the condition.
  
  
• Ethnic background: Some ethnic groups, such as African American, Native American and Asian Americans.
  
  
• Smoking: Smoking can increase the chance of developing insulin resistance and contribute to it.
  
  
• Sleep disorders: There is an elevated risk in conditions like sleep apnoea. 
  
  
• Stress: Long term stress may have an impact on blood sugar levels.
  
  
• Medical Conditions: The risk can be increased by other medical conditions like prediabetes or Cardiovascular disease.  
  
  

Now let us look into Sarah’s story and how she coped.

Sarah’s story

Sarah is a 16-year-old high school student who was diagnosed with type 2 diabetes mellitus six months ago during a routine check-up. She lives with her single mother and has an older sister who does not have diabetes. Sarah’s family history includes a grandmother with type 2 diabetes.

Since her first diagnosis, Sarah has been dealing with a variety of emotional issues. She holds herself accountable for getting type 2 diabetes. She thinks the problem was caused by her poor eating habits and inactivity. Her self-esteem has been severely affected by holding herself responsible for her current state. Since the diagnosis of type 2 diabetes mellitus, she has gained weight. She has become more conscious of her weight and her appearance. She avoids wearing tight fitting clothes and wears baggy clothes due to fear of body shaming.

Problems faced by Sarah with type 2 diabetes mellitus

Sarah frequently receives invitations from her friends to go out or share sugary snacks, and she feels under pressure to comply. She struggles to say ‘NO’ and frequently caves in to peer pressure, which causes her blood sugar levels to go out of control. Her diabetes has been the subject of crude remarks from classmates in the past. She now feels strange and ashamed of her current state.

TWT2DM also frequently compare themselves to their healthy peer groups. Sarah is keen to be socially accepted, however due to peer pressure she finds it difficult to follow a healthy lifestyle.

Given that T2DM and obesity are closely related, people with these two conditions face a constant battle to lose weight and at the same time keep their blood sugars under control. They may struggle with issues of body image and societal pressure to maintain a certain weight. This again is compounded by information obtained from different social media outlets.

Sarah’s problem

Due to her diabetes, Sarah feels she has no control on her life. She is overwhelmed by having to 

• Take medications 
• Follow a healthy diet
• Monitor her blood sugars regularly
  
  

Her mother, who is encouraging but occasionally intrusive, is very worried about how she is managing her diabetes. They routinely quarrel about Sarah’s food preferences and medications, which results in an unhappy situation at home.

Although many teenagers want to be more independent, managing diabetes frequently necessitates parental assistance, particularly when it comes to scheduling appointments, managing medications, and helping with lifestyle modifications.

It might be difficult to strike an ideal balance between independence and assistance. Frequent visits to medical appointments could have an impact on their academic performance.

Teenagers may be concerned about their long-term health and the possible complications of T2DM.

Solutions to manage TWT2DM

Here are few solutions to manage teenagers with type 2 diabetes mellitus:

Always plan ahead – By planning ahead and consistently addressing the aspects of diabetes management like meals, regular health check ups, medication adherence, physical activity in teenagers with type 2 diabetes can lead healthier lives and reduce the risk of complications in the long run.

Keep a routine – Establishing a routine not only aids in managing diabetes but also sets a foundation for a healthier lifestyle. It provides stability, predictability, and empowerment in effectively managing this condition.

Increase physical activity – Regular physical activity offers numerous benefits for teenagers with type 2 diabetes like blood sugar control, weight management, improves insulin sensitivity, reduces the risk of cardiovascular complications associated with diabetes, stress reduction, enhances mood and well-being. It’s important to note that teenagers should engage in a variety of physical activities they enjoy and can maintain regularly.

Reduce screen time – Encouraging teenagers to engage in alternative activities such as outdoor sports, hobbies, reading, or spending time with family and friends, rather than excessive screen use, can significantly contribute to better diabetes management by improving sleep, increased physical activity and reduced sedentary behaviour and overall health.

Avoid skipping meals – Avoiding skipping of meals supports a more stable blood sugar level, prevents overeating, ensures balanced nutrition, sustains energy levels, and facilitates better management of medication, all of which are essential in effectively managing type 2 diabetes in teenagers.

Maintain balanced diet –  A balanced diet tailored to the specific needs of teenagers with type 2 diabetes is fundamental in controlling blood sugar levels, portion control, nutrient balance, managing weight, reducing complications, and promoting overall health and well-being.

Avoid junk foods – Encouraging teenagers to opt for whole, unprocessed foods like fruits, vegetables, lean proteins, and whole grains over junk foods significantly contributes to better diabetes management by regulating blood sugar levels, supporting weight control, and enhancing overall health.

Maintain good sleep hygiene – Quality sleep helps regulate hormones responsible for hunger (ghrelin) and fullness (leptin). Poor sleep can disrupt these hormones, leading to increased appetite and potential overeating, which can impact blood sugar levels. Consistent, adequate sleep improves insulin sensitivity, helping the body effectively regulate blood sugar levels. A regular sleep schedule helps regulate the body’s internal clock, aiding in better overall health and potentially contributing to better diabetes management.

Have a regular health check up – Regular health check-ups serve as a cornerstone for proactive diabetes management in teenagers, facilitating early intervention, personalised care, and ongoing education essential for long-term health and well-being.

Sarah is coping well

TWT2DM can have a profound impact on a teenager’s emotional well-being, as illustrated by Sarah’s case. A holistic approach to care that addresses both the physical and emotional aspects of the condition is essential for helping teenagers like Sarah cope with the challenges they face and achieve better overall health and quality of life.

Conclusion

Teenagers with type 2 diabetes should be aware that despite this medical condition they can lead a normal good quality life and prevent complications. It is important to maintain a healthy diet, exercise regime and have regular medical check up. Support from healthcare professionals, peers, and family members can help  teenagers with type 2 DM to lead a happy and healthy lifestyle. 

The key to success is good communication with parents, teachers, friends and health care professionals.