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Question:

From Plantation, Florida, USA:

My 19 year old daughter is in the hospital with acute ketoacidosis. Her blood sugar was over 1,000 mg/dl [55.6 mmol/L], and after four days in the ICU, she is when she was admitted, and she is now in day four of an ICU stay and they are finally leveling off. What damage has this caused is left to be seen.

How can I convince her to try out a pump? I think it is the only way we can have some control over her highs and lows. She has a very erratic schedule (college, dating, etc.) and is a vegetarian. So, we are really struggling with this. She thinks it will be a cosmetic disaster -- showing through her clothes, etc.

Answer:

Tell her that Miss America 1999, Nicole Johnson, wore a pump her entire tryout year, during the pageant and through her entire year reigning at Miss America, traveling around the US and around the world. If Miss America can work out and wear tight gowns with a pump, the cosmetic issues can probably be overcome.

The issue is why she went into DKA [diabetic ketoacidosis] since this usually means either omitted insulin or lack of monitoring to recognize what to do during a sick day. You should have a frank conversation with her diabetes team to see what they think may be the cause so that as a parent of a young adult you can understand these dilemmas. At this age, obviously, your daughter must make such decisions about her own self care, responsibilities for her health and monitoring, followup and whether to use a pump or not.

The teaching manual, Insulin-Dependent Diabetes in Children, Adolescents and Adults - How to become an expert on your own diabetes by my friend and colleague Ragnar Hanas, available on this website, may be very helpful for you to read the adolescent/young adult section since it addresses some of these problems.

SB

[Editor's comment: While a pump would offer your daughter a great deal more flexibility and control over her blood glucose values, it is not the panacea you are looking for. Using a pump takes a great of commitment to learn to its ins and outs. Your daughter must be willing to make this investment of time. See insulin Pump Therapy and Is pumping for you?.

Also, see Miss America 1999 and Nicole Johnson Chat. On the chat page, there is also a link to her book, Living With Diabetes, in which she writes about her experiences being diagnosed with diabetes, the challenges she faced at college, and of achieving her dream of being crowned Miss America in 1999. This might serve as an inspiration for your daughter. SS]

DTQ-20020503183114
Original posting 1 Jun 2002
Posted to Insulin Pumps

  
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Last Updated: Tuesday April 06, 2010 15:09:34
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