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Question:

From Dana Point, California, USA:

Our 27-year-old daughter has had type 1 since she was 10. Her management is not good and has been that way since she was a teenager. She developed an eating disorder--spiking to lose weight--and went to a three month treatment camp at 16. Today, since she is now in complete control, she has put up a wall so that any comments we make about any aspect of her self-care lead to an immediate shutdown. She is in a continuing cycle of allowing herself to get low and then drinking juice (an average of 2 quarts a week) so that she spikes really high--and then she has to give herself way too much insulin to compensate. It's a roller coaster, but she thinks this is the normal way to manage her sugar and she balks when she is questioned about it in any way.

With a genius level IQ, she can talk for hours about how her diabetes is different from other people's and can also talk circles around anyone who cares to argue the point. She will post about her control problems on social media seemingly to get empathy and affirmation. She has three doctors who have told her that her sugars "are different," that carbohydrate counting doesn't make sense, that pumps and CGM's don't work for everyone, etc. We've given her access to every imaginable technology solution and she rejects them almost instantly. In spite of all this, she is the kindest, most genuine person you've ever met.

Are there any strategies you suggest to get through to someone like this? She really needs a powerful educator or a system to get her life in order immediately. She is already having some nerve pain and we don't want her to wake up blind one day. What would you advise us to do, as parents? Any thoughts would be greatly appreciated.

Answer:

Sadly, she is an adult who is refusing to seek care. There is nothing that can be done to force her to get care. What she is saying (her diabetes is different) is true but meaningless in that everyone’s diabetes is different. But hers is not so unusual that consistent and predictable care can’t help. There are many spectacular diabetes centers in California where she can receive great care if she is interested. She can also go to the program run by Bill Polonsky in San Diego for psychiatric care. But, she has to be interested in getting the care.

JWB

[Editor's comment:

There are two prominent adult endocrinologists in southern California who may be able to help her, if she is willing and if she has not already been seen by them. They are Dr. Anne Peters in Los Angeles and Dr. Steve Edelman in San Diego.

BH]

DTQ-20170708073520
Original posting 24 Aug 2017
Posted to Daily Care and Behavior

  
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Last Updated: Wednesday August 30, 2017 15:00:38
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