April 7, 2002
Question from San Raphael, Trinidad and Tobago, West Indies:
A staff member’s 13 year old who has been diagnosed with diabetes (I am not sure which type) is in the denial stage about her condition. She is embarrassed to take her insulin shots among her friends since there are no other children around her suffering from diabetes. Apart from taking her to a psychologist, what can the mother do for her child?
If this 13 old is on insulin, she almost certainly has type 1A (autoimmune) diabetes. Without knowing a lot more about her circumstances in Tobago, it is hard to do more than generalise. The problem has two aspects though and the first and by far the most important is to help with her denial and self esteem. Ideally, a medical social worker with experience in diabetes and with teenagers would be the best person to start trying to disentangle this problem, but failing that, you might be able to encourage some other valued acquaintance to help, a grandmother, an elder brother even a school friend. The doctor of course still has to say what is required.
The second aspect (and I emphasise a temporary one) is to enable this child to measure blood sugars and give injections unobtrusively. If it is available, a FreeStyle or One Touch� Ultra glucose meter would help. Also, giving her injection through a blouse or a skirt is also acceptable, if not desirable. Later of course, you hope she would not feel she had to conceal her diabetes. Finally, there is a small book by Jean Betschart and Susan Thom called In Control: A Guide For Teens With Diabetes which is published by and available free from the Juvenile Diabetes Research Foundation that might be very helpful to the mother and the patient.
[Editor’s comment: I would also recommend another book called Sweet Kids: How to Balance Diabetes Control and Good Nutrition with Family Peace by Betty Brackenridge and Richard Rubin, It is chock full of suggestions for dealing with some these issues.