The best way of encouraging teenagers with diabetes to look after themselves is to focus on the positive things they are doing, rather than pointing out what they are doing wrong, a psychologist has said.

According to Vincent McDarby, a senior clinical psychologist at Our Lady's Hospital in Crumlin, teenagers can become ‘very discouraged' if their visit to a diabetes clinic focuses ‘primarily on what they are doing wrong'.

"If the focus is totally on targets they did not meet, rather on those they did, the teenager is going to say ‘why did I bother? I've made all this effort, but my parents aren't happy, the diabetes team aren't happy. I haven't achieved anything'," Mr McDarby explained.

He insisted that parents and health professionals need to acknowledge how difficult managing diabetes can be and to focus on any achievements, no matter how small.

"Acknowledging what an adolescent has been able to achieve helps them to better deal with setbacks. People who go on diets have setbacks, so we have to accept that adolescents with diabetes have setbacks as well," he said.

Mr McDarby pointed out that diabetes can be difficult for teenagers to deal with because one of their main concerns is ‘conforming with peers'. However, he pointed out that during adolescence, ‘children start to take over more responsibility for their diabetes management', although there is no set age for this.

"Children generally start to develop responsibility and independence as they need it themselves. As such, there should be no need to push independence with regard to diabetes management onto a child," he explained.

He noted that some teenagers find it difficult to achieve good diabetes management, but this is not because they do not care, it is simply because they may genuinely find it difficult.

"Even though some adolescents may say they don't care about their diabetes management, they will always feel an underlying sense of guilt. They'll take a couple of steps towards better management, but feel frustrated if they don't achieve the goals set out for them.

"This sense of frustration can serve to erode the adolescent's belief in their ability to successfully manage their own diabetes," Mr McDarby said.

As a result, he insisted that teenagers with poor diabetes control should never be called lazy or be punished for this.

"The child didn't ask to get diabetes so I don't think it's appropriate to punish them for difficulty managing it," he said.

He pointed out that adults are not very good at health changes. For example, how many people fail to quit smoking or do not stick to diets.

"We fail all the time in relation to making health-related behaviour changes and yet we expect adolescents with diabetes to make significant health-related behaviour changes without difficulty."

Mr McDarby made his comments in the journal of the Diabetes Federation of Ireland, Diabetes Ireland.