How can a 14-year-old manage symptoms and risks of T1D?

Question

Hello doctor,

My 14-year-old niece was diagnosed with type 1 diabetes three months ago, and she has been struggling to adjust since then. She has recently gained weight, and her blood pressure has increased to around 135/85 mmHg. Her HbA1c is 9.2 percent, and she is currently on insulin glargine and rapid-acting insulin.

We are particularly concerned because she experiences constant fatigue, has developed dark patches on her neck, and finds it hard to concentrate on her studies. Previously, she was an active sportsperson, but now she is reluctant to participate in physical activities, which adds to the concern.

The doctors mentioned continuous glucose monitoring (CGM) as part of her treatment plan, but we are unfamiliar with how it works or its benefits. We are also worried about the potential long-term complications of diabetes and how to help her better manage her condition physically and emotionally.

Could you please guide us on:

The possible causes of her weight gain, high blood pressure, fatigue, and dark patches on her neck.
How does continuous glucose monitoring (CGM) work, and can it improve her condition?
Ways to encourage her to engage in physical activity and manage her diabetes more effectively.
Steps to minimize the risk of long-term complications.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I am truly sorry to hear about the challenges your niece is facing with her type 1 diabetes. Managing this condition can be difficult, especially for a teenager, but things can improve significantly with the right steps.

Causes of weight gain and high blood pressure

Insulin therapy: Insulin is essential for managing type 1 diabetes, but one of its common side effects is weight gain. This occurs because insulin helps the body use glucose effectively, storing any excess as fat.
Hormonal changes: At her teenage age, hormonal fluctuations during puberty can further contribute to weight gain and metabolic changes.
Thyroid function: It is important to check her thyroid levels (TSH, T3, T4), as type 1 diabetes increases the risk of autoimmune thyroid disorders, which can cause fatigue, weight gain, and metabolic imbalances.

Continuous glucose monitoring (CGM): how it works and its benefits

CGM is an excellent tool to help manage her blood sugar levels and reduce the risk of complications. Here is how it works:

A small sensor is inserted under the skin (typically on the arm or abdomen). This sensor measures glucose levels in the fluid surrounding the cells (interstitial fluid).
The sensor transmits glucose readings wirelessly to a device like a smartphone, a standalone reader, or an insulin pump.
CGM provides real-time glucose data, including trends and patterns, helping to identify highs and lows before they become severe.
It reduces the need for frequent fingersticks and improves blood sugar control, which can also help manage fatigue and weight gain.

While CGMs can be expensive, many insurance plans now cover them for eligible patients. It’s worth discussing this option further with her doctor.

Long-term complications and prevention

Uncontrolled blood sugar levels over time can lead to long-term complications such as:
Cardiovascular issues (hypertension, heart disease)
Kidney disease (nephropathy)
Eye problems (retinopathy)
Delayed growth and puberty
Osteopenia or osteoporosis (weakened bones)
Mental health challenges (anxiety, depression)

The best prevention is to keep blood sugar levels stable. This requires:

Effective medical management (insulin therapy, CGM use)
Balanced nutrition (a diet tailored to her needs by a diabetes dietitian)
Regular physical activity to improve insulin sensitivity and overall well-being. Start with small, enjoyable activities she feels comfortable with.
Psychological support: Diabetes can feel isolating for teenagers. Encourage open communication, peer support groups, and reassurance that she’s not alone in this journey.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.