From California, USA:
My 12 year old daughter, who was diagnosed with Type 1 a year and a half ago, is having a extremely difficult time maintaining control of her diabetes. She currently takes 24 units of NPH and Humalog in the AM, Humalog at lunch, and Humalog and 14 units of Ultralente at dinner. She constantly has blood sugar readings in the 300's and it's not unusual to be in the 400's, especially before dinner. She has regular doctor's visits every two months, and has met with a diabetes education team at our hospital, including a dietitian, nurse educator and social worker. We follow the prescribed diet guidelines and insulin dosages, but are always frustrated with the results. Is this common for an adolescent to be this out of control? She worries about dying because she is unable to maintain the control she needs. Her doctor is not very helpful; he simply scares her at every visit about what will happen to her if she doesn't maintain control, but never offers any realistic suggestions on how to achieve that control. Any suggestions?
Adolescence really does make management a bit harder, but for those who want to do better, we usually can actually do better that you describe. While it may seem a bit mean, I must tell you I see children who are not taking insulin, and their parents think they are taking insulin. Be sure you are not in this group, first of all. Also, the timing of after school food can mess up the best intentions. Maybe Humalog at snack would help.
Lastly your team needs to be supportive. Your team needs to be willing to do whatever it takes to control the diabetes.
Additional comments from Dr. Quick:It was unclear from your letter if your daughter is seeing a team that's used to dealing with kids and adolescents; certainly, from your description, the doc's attitude is counterproductive for helping teenagers cope. You might want to consider seeking advice from a pediatric endocrinologist and/or a counselor to help your daughter make the teens transition smoother.
Last Updated: Tuesday April 06, 2010 15:09:01
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