Q: Our daughter’s getting older, and we’re afraid of one day catching her drinking alcohol — or worse yet, with dangerously low blood sugar because of it. What can I do now to address this?

A: There is not a simple solution here — you’re both addressing illegal underage drinking and figuring out how the added layer of diabetes fits in. However, there are some ways to begin a conversation with your child that will hopefully prevent a situation like this from happening.

For starters, take a minute to honestly assess how much — and how deeply — you and your daughter have discussed topics like underage drinking, peer pressure, and your expectations for her when she spends time with her friends. As much as parents may want to think their child won’t engage in this kind of behavior, or it’s only something to worry about “later,” the truth is, it’s not unheard of for even younger tweens and teens to experiment with alcohol. So if you’ve never said this out loud before, now is the perfect time to make sure your daughter hears the message loud and clear that it is illegal to drink when you are underage and that your expectation is that she will not do it. Period.

What else should she hear? That she can always talk to you about these kinds of tricky issues and, especially, that she can reach out to you for help without fearing your reaction. Come up with a mutually agreed upon plan that if she ever finds herself around alcohol, she can text or call you to come pick her up, no questions asked — and no angry response on your end. At the same time, it’s also important for her to be aware that when it comes to poor decision-making on her part, her actions do have consequences, not the least of which is weakening your trust in her.

Now, let’s tackle the equally difficult issue of how to manage diabetes in the face of peer pressure. Has your daughter ever learned how alcohol affects blood sugar? It may be intuitive to think that since alcohol contains carbohydrates, it would raise numbers, but this is typically not the case. Alcohol is processed in the liver, where it essentially ties up that organ from doing anything else for several hours after drinking. This means that the liver won’t be available to release stored glucose, should it be needed, until all the alcohol is cleared out — putting people with type 1 diabetes at risk for an alcohol-related low for up to 12 hours after drinking. Drinking on an empty stomach amplifies how bad the low can become.

Your daughter’s diabetes could be her perfect excuse for escaping peer pressure. Chances are if your daughter explains, “Alcohol makes people with diabetes have a blood sugar low, and I’ll get really sick,” the company she is with will back off long enough for her to send you a text — and long enough for you to pick her up and tell her that you’re glad she did.

–Deborah Butler, M.S.W., L.I.C.S.W., C.D.E., is associate director of pediatric programs at the Joslin Diabetes Center in Boston.

How Other Parents Deal

“Our son’s older sister blazed a trail through the teen years, so I already had an idea what to expect. However, I was so used to my son being responsible — because he had to be with his type 1 care — that when he started to make many of the same bad choices his older sister had, at first I was shocked. And then I realized the middle and high school years are difficult, whether or not a child has diabetes. Get ready for some tough conversations.”

— Karen L., Los Angeles, mom of 18-year-old David

Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.

Related topics:
Discipline and Type 1 Diabetes
When Tweens Become Teens: Parental Guide Suggested
People in the Know: Tween Rebellion

See more People in the Know questions and answers >