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Question:

From Brevard, North Carolina, USA:

My 15 year old daughter has had type 1 diabetes since she was seven and has been on the insulin pump for two years, and we are having a lot of trouble getting her to check her sugar and bolus. Her hemoglobin A1cs stay around 8-9%. She's not insolent when we remind her, but she just doesn't do it and is incredibly nonchalant about it. We've gone from reminding her a dozen times a day to just letting it go to see if she will do it on her own ( which she usually doesn't). We've talked with her, her endocrinologist has talked with her, and while she knows what she's supposed to do and why, she just doesn't do it. My heart is breaking because I know the complications can happen to her even if she doesn't believe they will. Do you have any suggestions?

Answer:

Your daughter is only 15 years old. Most teenagers are not capable of managing the responsibility of the demanding and exhausting diabetes regimen on their own. As you have personally experienced, most teens feel burned-out by the demands of the regimen after a while (no matter how enthusiastic they were before). Your daughter's behavior (not checking her blood sugars) is her way of telling you that she is not able to accept this responsibility on her own.

You will need to take over her blood sugar checks right now. Do not ask her to check, do not remind her to check. Just bring the meter to her, poke her, and get the information you both need for her to make safe choices about her basal rate and bolus doses. This will decrease the nagging you are doing and the anxiety you are feeling. It will also help your daughter feel safe.

You should also ask your daughter's endocrinologist for a referral to a mental health professional with expertise in working with individuals who live with a chronic illness. Your daughter would greatly benefit (both from an emotional and a physical perspective) from meeting with someone that can help her problem-solve around making safer choices for her health.

JWB

DTQ-20021007201646
Original posting 15 Oct 2002
Posted to Behavior

  
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Last Updated: Tuesday April 06, 2010 15:09:38
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