My 15 year old son’s diabetes was diagnosed at age eight, and has never been under control, but the doctors are blaming me even though they were unable to get him stable during a hospital stay. His doctor is refusing to try a new medication because the one he is using doesn’t seem to be working. I’d like to try he pump or the meter that goes on the wrist, but they are not hearing me and do want to anything new. Instead, they called the authorities on me and say I am not doing my job, but they are willing to try and help in other ways. What can I do?

I understand your frustration, but without more information, it is hard to give advice. Many times, such a concern from health care people really relates not to the parents “doing something wrong” but rather concerns that the parents are not really taking control. It’s hard to control and supervise a 15 year old. You probably want him to be more independent, but it sounds as if he needs even more supervision and maybe a psychologic counselor.

However, I think that if he is not in good control, the use of an insulin pump may not be a good first step. Does your son know how to carbohydrate count? Accurately? All the time? Is he already on an insulin regimen that allows flexibility in meal timing and amount that bases his doses at meals with carb counting and also uses a long-acting insulin (like Lantus (insulin glargine) or Ultralente) for a relatively “constant” amount of insulin? If the answer to any of these questions is “no” then you may want to discuss these issues first with your diabetes team.

The “meter on the wrist” (the GlucoWatch) that you mention has many, many pitfalls and has rather limited applications in its present form. It does not take the place of a regular glucose monitor and finger sticks. If he is not using a meter that allows Alternate Site Testing on the arms and thighs, you may wish to discuss this with your diabetes team also.

DS