A new study by a team at the BD Diabetes Center at Atlantic Health System’s Goryeb Children’s Hospital, headed by Harold Starkman, MD, director of pediatric endocrinology, found that teens with poorly controlled type 1 diabetes can experience anger, frustration and anxiety, fraying the relationships they have with their parents and health care providers and impacting their treatment and self-management. A better approach, the team found, was for parents and providers to reduce stress and promote success by simply listening to patients as they describe their efforts and struggles.
In order to control blood sugar levels, people with type 1 diabetes must test their blood frequently and take insulin, which requires diligent monitoring. For teens, this can be especially difficult while managing school and extracurricular activities.
Dr. Starkman and his team, which included Nicole Pilek, MSW, LCSW, the pediatric endocrine social worker at Goryeb Children’s Hospital, and Gloria Lopez-Henriquez, a counselor at CONCERN Behavioral and Management Solutions, recruited nine teens between the ages of 13 and 18 who had been diagnosed with type 1 diabetes more than a year earlier and had average hemoglobin A1C levels (a test that measures blood sugar levels over a period of several months) of more than 9% – which is well above normal.
The team interviewed the seven girls and two boys, all patients at Goryeb Children’s Hospital, with their parents. They also interviewed 10 health care providers in separate sessions.
The interviews revealed significant conflict, potentially impacting treatment. The teens often expressed not feeling understood, even as they tried to control their disease; parents expressed their fears as anger at their children; and health care providers distanced themselves by focusing on blood sugar levels instead of seeing patients as busy teens who were doing the best they could.
By acknowledging patients’ efforts and being sensitive to the feelings of all involved, say the researchers, the chances of patients being better able to control their blood sugar increase.
“The idea is to transition from a focus on numbers to an understanding that the relationship between patients, parents and health care provider is critically important, and can motivate patients to be more engaged and improve their health,” says Dr. Starkman. “This kind of listening and understanding can prevent adolescents from dropping out of medical care.”
The study was published in the March 2019 issue of the American Psychological Association’s Family, Systems and Health journal.
Dr. Harold Starkman is part of Atlantic Medical Group, a multispecialty network of health care providers. Dr. Starkman can be reached at 973-971-4340. The BD Diabetes Center/Pediatric and Endocrine Center is located at 55 Madison Ave. and can be reached at 973-971-4340.