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February 18, 2005

Behavior, Mental Health

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Question from Ocean City, Maryland, USA:

When preparing for our three month check up, I was downloading the glucose numbers and found they did not match with what my son had been telling us. He would say 123 mg/dl [6.8 mmol/L] when then meter said 570 mg/dl [31.7 mmol/L]. He was doing this since a Christmas party ended up in a bad number and he lied about it. From then on, he lied more and more frequently and I found a total of 21 episodes of HI readings in February alone.

On the way to the visit, he started crying and stated he wanted to die because this diabetes is so hard and I just did not understand. The doctor’s advice was to start fresh as if we were just diagnosed and go from there. He also suggested that we seek a counselor for him. He has had diabetes for ten years, since infancy. Has anyone else had this type of experience?

Answer:

From: DTeam Staff

To answer your last question, several other families have gone through very similar experiences. It is natural for children to want to please their parents and their health care teams with in range blood sugar numbers. Unfortunately, the blood sugar log book can become like a report card, so the kids (teens and adults can do this, too), tell the parents the numbers they think they want to hear so they can get positive reinforcement. A number in the 100s mg/dl [5.6 to 8.9 mmol/L] may feel like an “A” to the child and a number in the 500s mg/dl [27.8 mmol/L and up] may feel like an “F.” The key is to look at all blood sugars as “good” information, regardless of the number. I know this is not easy to do. Sometimes I recommend that families hold a mirror to their face when they see the blood sugar numbers on the meter because the kids can definitely pick up the non-verbal behavior.

I agree with your doctor that you need to start over. I recommend that you take over all of the diabetes tasks, because it sounds like your child is very burned out from diabetes. I also agree with your doctor’s recommendation that your and your child should meet with a counselor (psychologist or social worker). It worries me that your child said that he wanted to die, so, I think he needs to be seen by a counselor right away to assess for safety as well as find ways to support how he is feeling. Your child’s diabetes doctor may be able to give you the name of a counselor that is knowledgeable about diabetes related issues. You could also ask your child’s pediatrician for a referral.

DB