February 20, 2002
Behavior
Question from Brooklyn, New York, USA:
My soon to be 13 year old daughter, diagnosed with type 1 diabetes two years ago, has had a very difficult time with the whole process, both physically and emotionally. She has been depressed throughout the process and is refusing to continue therapy. Along with my concerns over her emotional state, we have not been able to keep her blood glucose levels in a healthy range, and more recently, they have been in the 400 mg/dl [22.2 mmol/L] range.
She is not willing to be part of her care and is refusing to test herself consistently. She is often fatigued, is not sleeping at night and wants to sleep all day, and is eating whatever she wants (often buying candy after school). She has been getting sick with lots of headaches, stomachaches, body aches, colds symptoms, and recently she has been experiencing something I have never heard of. In the middle of the night, she is getting the shivers and her body is extremely cold to the touch (mostly in her feet, legs and hands).
We had been working with a clinic, but both she and I were not feeling comfortable with the doctors so now she has a specialist through her primary physician. However, I feel like she is slipping through the cracks, and I don’t know where to turn to find her more help. I read about a clinic where they do a lot of work with children with diabetes, and although it is quite far from us, I am wondering if it would be wise to change. I know that I need to do more for her and am asking for any guidance.
Answer:
Your daughter needs help — both from an understanding and compassionate diabetes team, and from a mental health professional with experience in working with teens who have diabetes. You may wish to ask your pediatrician and/or your local American Diabetes Association office for recommendations about pediatric diabetes teams. If the “best” one is far away, go there anyway, if only for a consultation. It may be very helpful.
Finally, at this point, like many youngsters her age, your daughter is not capable of being responsible for their own diabetes care. They get tired of it, forget to take their shots, etc. Please do all your daughter’s blood sugar checks and give her all of her shots for a while. She has shown you that she cannot, in any way, take that responsibility on right now. Therefore, you must do it for her, so that she is safe.
JWB
