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From Eugene, Oregon, USA:

My nephew, who will be turning 13 next month, will be coming to stay with us in about a week. He was diagnosed with type 1 diabetes at the age of five. For about the last year or so, he has struggled with high blood sugars and the desire to help manage his diabetes. He has gotten to the point of using his diabetes as a way to get out of attending school. (examples: not taking bedtime dose of NPH so that blood sugars will go high and more than likely produce ketones, stealing money to buy candy bars from school vending machines, etc.) When ketones of any type are present, he is unable to attend due to district regulations. He is lying about taking his medication and checking his numbers, sneaking inappropriate foods, stealing money to purchase high sugar/high carbohydrate foods, etc. This behavior is spilling over to other areas of his life including school and personal hygiene. We are also seeing other typical pre-teen/teenage behaviors. His move to our house is so that he can be the only child in the house (he has three brothers and sisters) and to work towards a better attitude and acceptance of proper care of himself and to improve his behavior. We are hoping that the 2 to 1 ratio of adults to kids will make it easier to monitor him and to help correct his destructive behavior. Are we taking the right steps? Is there anything else you can suggest?


I think you are taking some positive steps and major kudos to you for trying to be a positive influence.

Some other considerations for you to include:

  1. What is the duration of this move for him? If it were only for a few weeks, it might not have the impact it would have if it were longer, like the school semester.

  2. Will this be a new school? If so, there may then be other "coping stresses" that come into play. On the other hand, this allows a "clean slate."

  3. Does he see a professional counselor such as a psychologist? I would strongly recommend this. You probably have recognized some important aspects as to the issues and the problem, but what is the root? How depressed is the young man? I am disturbed that something very serious is going on when I hear that personal hygiene issues have come into light.

  4. Will you all be giving him a real "diabetes vacation" by taking over ALL his diabetes tasks (blood glucose checks, carbohydrate counting, insulin administration)? I encourage you to do so, for at least a couple of weeks.

  5. Is the young man's regular pediatric endocrinologist or diabetes team privy to this plan? How can they help you more?


Additional comments from Dr. Jill Weissberg-Benchell:

I recommend that you and/or your husband take over complete control of your nephew's diabetes care. This is to ensure that his blood sugar is being checked and that he is getting his insulin. This is a non-negotiable condition for spending time with you.


Original posting 24 Mar 2009
Posted to Behavior


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Last Updated: Tuesday April 06, 2010 15:10:18
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