Adolescents often know what they are supposed to do, but don't do it anyway. (See: homework, chores, junk food, hygiene, etc.) Turns out, they can be just as reckless when dealing with their own type 1 diabetes.

National studies show that blood sugar levels worsen when diabetic children reach their adolescent and teen years. Often due to disbelief or despair -- or because they assume more responsibility from their parents -- diabetic teens get a little sloppy with their diet, exercise and medication habits.

"The most difficult time for kids … is the transition from being sort of under the care of their parents to more of an independent role as they are maturing to become adults," said Dr. Brandon Nathan, a specialist in pediatric endocrinology at the University of Minnesota. "It's a time when adolescent patients are really looking at 'why me? I don't want to do this any more,' even though they often times know the consequences of not dealing with the disease."

A U of M study is testing a solution that researchers hope will motivate teens with type 1 diabetes to take better care of themselves. Instead of the usual treks to clinics to talk with doctors and nurses, diabetic teens will participate in online clinic visits and view educational materials created at the U of M in which the information is delivered by teens.

"We really wanted to harness the power of an adolescent delivering information to another adolescent," Nathan said. "What doesn't work with adolescents is adults giving them the scared straight talk ... That's just not an effective way to communicate with them and get messages across."

Getting a handle on teen diabetes is significant. Some public health experts predict a tripling of type 1 diabetes cases in teens over the next 40 years. Type 1 is an autoimmune disease in which the body produces no insulin at all to move sugar from the bloodstream. Type 2 is when the body starts to produce too little insulin, often as a result of poor diet and exercise. Both diseases can result in severe health problems if they aren't managed.

The U of M will test its online education on 20 teens with levels of type 1 diabetes that are so severe that they need insulin pumps to maintain their blood sugar levels. Half the teens will receive the online education and the other half will receive standard medical care and education. Nathan said the researchers will monitor the teens in part by how they use their insulin pumps and whether they are able to maintain consistent, healthy blood sugar levels.

"The goal is to really empower them with this knowledge so it's not just us telling them what to do," Nathan said. "We never want to let diabetes get in the way of what they want to do, whether it’s a sport ... or some other activity. We want them to learn how to make sure their diabetes fits into whatever they want to do."

The study is part of the postdoctoral fellowship of Ewa Oberdorfer in the U of M's pediatric endocrinology program. If the approach proves effective, it could be studied in a larger group and then one day used broadly by clinicians. Interested families can contact Nathan at or 612-625-6738.

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