From Merrimack, New Hampshire, USA:
My 13-year-old old son was diagnosed at age two, pumping from ages 4 to 11. At age 11, he rebelled and agreed to return to shots. Last spring, he asked to resume pumping. He has turned to lying about doing his blood sugars, lying about checking his ketones, doing a meal bolus without a correction because he doesn't want to check his blood sugar. His most recent A1c was 9.2, the highest since his diagnosis. If I leave him to take care of his pump, he may or may not do it. Since he is going through a growth spurt, I expect his blood sugar to be high, but the doctor cannot change his basal/bolus without "good numbers," which we don't have. If I do his blood sugars and take responsibility for his pumping, then he cannot go to friends' homes without me and he doesn't want that either. If I go with him (visit with the mom; go as a chaperone; be as non-conspicuous as possible) and I just quietly remind him to do his blood sugar or bolus, he gets annoyed and is disrespectful. I try not to limit his choice in food (he can have cake, ice cream, candy, pizza, etc. in moderation and covered with a bolus). As a parent, what should I do?
You have every reason to be worried about your son, and your thoughts about taking over his care are correct. I do not know why he is reporting numbers to you that are inaccurate (there are probably 20 good reasons for kids to not tell others their accurate numbers, including: not wanting parents to be upset, wanting to make parents happy, not wishing to have a confrontation, not wishing to be micro-managed, etc., etc.), but it will be important to have a discussion about that. His reasons may surprise you. Also, I do not know why he misses meal boluses, but there are as many reasons to miss boluses as there are reasons to not report numbers. Again, I'd encourage you to ask your son what the varieties of barriers are for him.
In addition to the conversation, the bottom line is that diabetes care must be done. He is not doing it, therefore, you must take over. He may not like this, but that’s a choice he has made by not engaging in the tasks that need to be completed. Once he honestly reports numbers and boluses accurately, then you can stop doing these things for him. He may not like this, but it does not matter. It’s his health and safety at risk.
That said, he may be willing to engage in a conversation where there are certain things he is upset about/finds difficult that can be resolved so that you do not need to take over all of his care. For example, some children become very upset when parents ask about the numbers so they make numbers up. BUT, they'd be perfectly content to have their parents look at their meter and find the numbers themselves - as long as there isn't a long discussion about every single number. This may be so for your son.
In sum, have a conversation. Be open to his ideas/thoughts. If, after the conversation, he is not able to engage in safe behaviors, you need to take over whether he likes that or not.
Original posting 20 Dec 2011
Posted to Behavior
Last Updated: Tuesday December 20, 2011 18:06:12
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