Adolescence is a time of major changes; physically, intellectually, emotionally, and morally. Teens are preoccupied with the physical changes in their bodies and distracted by normal developmental milestones such as the need to create a sense of self, while simultaneously conforming to their peers, and wanting to “fit in”. These developmental changes are often in conflict with the demands of diabetes as a primarily self-managed condition.

In managing diabetes teens want more independence. However, many studies show that early independence from “family management” is associated with deterioration in the metabolic control of diabetes, reflected in higher A1C throughout adolescence. The more independence the teen has, except in rare circumstances, the higher the A1C tends to be. While the teen may desire to be “in control”, the competing outside world of wanting to “be like everyone else” often leads to missed blood glucose (BG) checks, injections, boluses etc… In order to save face, the teen may not be disclosing to his or her family how difficult things are and it often takes a clinic visit to reveal missing BG checks on the meter/pump download.


Our philosophy at the Madison Clinic is to help parents/guardians anticipate these very normal struggles before their children arrive at puberty, and before they experience the associated  behaviors that may create tension in a family system that may have been working quite well before adolescence. The diabetes team at the Madison Clinic understands that these are normal stages in a teen’s life and we assist the families in negotiating the tasks of managing such an intense condition as diabetes.

As teenagers emerge and transition into young adults and take on more responsibility not only for their diabetes but their life, we lead the nation in our approach with the Transition Program. We believe in preparing this population for success in a smooth transition while offering to continue care well into their third decade of life.