I am concerned about my daughter, who has such erratic diabetes control and an eating disorder. Her BG was over 1000 mg/dl [55.5 mmol/L] at her last appointment with the endocrinologist. What are the risks of driving while having a high blood glucose level? Secondly, we are frustrated with mental health insurance which covers up to 30 days per year. We keep exhausting our insurance before she can recover. What are our other options for long term care? All the treatment centers for eating disorders cost around $200 to $2000 a day.

As for the issues of mental health coverage, I agree it is a terrible situation. I do not understand why this seemingly is seen as “less important” to third party payers. I presume that in-patient mental health has been approached because out-patient approaches have hit a snag.

My stand on that places the burden on the psychiatrist of record. If they believe that in-patient assessment and treatment is “truly” required for an extended time, they are the best ones suited to appeal to the insurance company. I believe in the “squeaky wheel gets the grease” theory and if you think you are being dealt with unfairly by your insurer, do not hesitate to threaten to call or actually call your state insurance commission.

As to driving with a blood glucose over 1000 mg/dl [55.5 mmol/L], that puts the individual at risk of severe dehydration and, of course, diabetic ketoacidosis, which may be life threatening, as you well know. More acutely, a glucose that high can be associated with strokes. Normally, blood is pretty thin. But, imagine if you had syrup in your veins. Blood wouldn’t flow as well when thick and could easily lead to clogged blood vessels and lead to a stroke. She needs to get that blood sugar down with insulin and assure good hydration.

DS