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Question:

My daughter is in the seventh grade this year. She was diagnosed with type 1 at age six and has been on an insulin pump for almost 2 years. She is doing beautifully physically as well as mentally. Her last HbA1c was 6.7%, and her random cholesterol was 160 mg/dl. Since she has had the pump, she eats more of what her friends eat. We have not restricted her, but we try to guide her to healthy food and exercise. She said the other day that she knows that her diet has not been as good as it was when she was on injections because she can cover her carbs. She has decided, on her own, that she will try to eat less junk food. I felt that this was more important for her long term health that she came to this conclusion, than having her parents and others forcing her to eat "differently".

This past week, we had an incident at school that has devastated her. A teacher told her that all of her teachers had been watching her and they have seen her eat "ice cream" at lunch. They have all agreed that she needs to go on a "diet". This was actually the second episode of this nature. Another teacher had made her take a test that she didn't know about because she had gone "high" and had to leave the class, before being told that the test the was the following day. When my daughter told her that she was not informed about the test and could she take it after having a chance to study, she was told, "No. It was your fault that you missed the class! I know that you ate french fries at lunch!" She took the test and failed. Actually, she had forgotten to cover her lunch that day; only the second time in almost two years. (Not bad for a kid who, on her own, checks her blood sugar an average of ten times daily, and boluses insulin every time she puts anything in her mouth!)

We handled the first episode by educating the teacher and things worked out beautifully. Now, however, the teacher that we are dealing with now seems to feel that by my daughter's disclosure of this episode, she will be cold t o my daughter for her action.

I am a family nurse practitioner with ten years of experience. The teaching staff knows this, yet they are unwilling to accept the fact that having diabetes does not mean she can't eat as others do. I would like some advice on how to deal with the psychological damage that is being done to my daughter. I have tried so hard not to have food as an issue so as to avoid an eating disorder.

I would like to present these teachers with the facts about diabetes care. Please explain the current thinking about diet and teenagers and possibly explain the difference between type 1 diabetes care vs. adult onset diabetes care.

Answer:

It sounds like your daughter is doing exceptionally well in living with diabetes. She is able to show more responsibility (testing 10 times/day, sophisticated carb counting) than most people with diabetes, and she's just a young teenager!

I have to assume that her teachers actually have her best interest at heart and just are sadly misinformed about food and diabetes. With the use of Humalog and carb counting, there just is no such thing as a forbidden food anymore. The only danger your child faces if she eats more food than she should (assuming she is bolusing to cover), is that she will gain weight. This is true for every human if they eat more than they should and has nothing to do with diabetes.

The lesson your daughter can learn from this experience is that most people know absolutely nothing about diabetes, and yet they believe they know everything. Talk about this with her and help her develop some strategies for coping with such people. How does she want to respond to these "experts"? Does she want to ignore them? Educate them? Pity them?

JWB

DTQ-20000203225037
Original posting 23 Aug 2000
Posted to Social Issues: School and Daycare

  
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Last Updated: Tuesday April 06, 2010 15:09:12
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