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Question:

From Massachusetts, USA:

I am a school nurse and have a 16 year old female student with type 1 diabetes diagnosed at age 6. Her blood sugars run very high, usually in the 300 - 350 range. They remain high even after taking insulin or exercising and even if she doesn't eat after administering her insulin. How can this be possible? I keep waiting for her to become comatose but other than a stomachache or headache she carries on as usual. My fear is that she's also becoming anorexic because she can see that nothing untoward happens to her if she doesn't eat. Any suggestions or solutions?

Answer:

Your question brings many questions to my mind. I too am a school nurse and am often frustrated by the fact that I can't help my students 24 hours a day. During the school day I try to do lots of teaching and help the kids learn from how they manage their diabetes at school (i.e., extra testing to see the effect of an insulin decision).

This young lady sounds like she needs the support of a diabetes team. Perhaps you could contact her parents/guardian and express your concern and help them establish the contacts they need. Teenagers with diabetes have so many issues, and not eating and exercising with a high sugar may only serve to drive the blood glucose higher. Emotions of guilt and frustration may be factors. I know an experienced diabetes team and perhaps some other teen support would be helpful.

LW

Original posting 10 Nov 1998
Posted to Hyperglycemia and DKA and Social Issues: School and Daycare

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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