Adolescence

Alcohol, smoking, drugs

• Advice on alcohol, smoking and drugs including encouragement to refrain from smoking and under-age alcohol, and firm advice on the dangers of addictive drugs

• Adopting a realistic advisory approach to alcohol rather than an absolute ban
• Information on the dangers of alcohol particularly in young adolescents, its effects on the liver by inhibiting gluconeogenesis, and the possibility of delayed hypoglycemia
• Advice on preventing nocturnal hypoglycemia after drinking alcohol in the evening. This should include advice on eating food while drinking, maintenance of good hydration, measurement of BG level before bedtime, and eating before bedtime to minimize the risk of hypoglycemia during sleep
• Warning adolescents on the dangers of binge drinking, particularly the risks of vomiting, aspiration and DKA

Friends and relatives of adolescents with diabetes who drink alcohol should understand that hypoglycemia might be confused with intoxication and that it is important to eat carbohydrate before sleep

• Firm advice about smoking as an additional risk for the vascular complications of diabetes
• Helping the adolescent who does smoke to stop by providing specific advice

• Information on driving including

• Provision of supportive information about diabetes for potential employers when applying for a job
• Prevention of hypoglycemia whilst driving (particularly if hypoglycemic unawareness is a problem) by BG monitoring and appropriate food intake
• Encouraging stable metabolic control (particularly avoidance of severe hypoglycemia), which helps driving licence authorities in some countries to award a driving licence
• Regular visual acuity and retinal checks