I am 21 years old and was diagnosed with type�1 diabetes just before I turned two. Once I was able to administer my own insulin injections and test my blood sugars myself, I was given much more autonomy around my health and diabetes care. My mother regularly inquired about my blood sugars and generally attended doctor’s visits until I was an adolescent, but let me try to manage for myself.

Since that time, I have been noncompliant. I have not tested my blood sugars regularly, and have not taken insulin as scheduled or prescribed. I have been told repeatedly by numerous professionals, friends, and family that my diabetes care should be the top priority in my life, though it seems to me that I have always made it, at best, secondary. I have spent a considerable amount of time pondering why I have behaved this way for so long, and why now, even in my stage of recognizing where I have made mistakes and maybe why I have made them, I cannot seem to get on track. I am curious to know if this childhood experience with diabetes is normative, and if you have some suggestions for a complication-free (for now), young adult who really wants to establish healthier life patterns before habitually poor control gives way to manifestations of deteriorating health in other systems. As an aside, I have recently begun seeing a therapist and have discussed, at some point talking about my noncompliance and diabetes as they relate to some of the issues I am trying to resolve in therapy.

It sounds like you are on the right track with talking to a therapist. Your choices to not care for your diabetes clearly are yours to make, but you will pay a very high price of having diabetes related complications from these choices. If you decide that you want to care for yourself in a better fashion, your first chore should be to learn why you made these choices for so many years.

Therapy will help. You should also consider finding out how much you know about diabetes by talking to your diabetes health care team and working closely with a dietitian and nurse educator as well as your physician. You have to have a relationship where you can learn, question and ponder what you know, what you need to know, and how to get there. If you do not have such a relationship, then consider changing to another diabetes team where you can start fresh. There are many diabetes teams available in New York who can help assess where you are at medically and psychologically, and point out what you might need to do to start turning things around.

Subscribing to Diabetes Forecast and Diabetes Interview would give you some information. Becoming a member of the American Diabetes Association and Juvenile Diabetes Foundation would also help give you current information. The young adult Chat Rooms at this and other diabetes web sites might also be very helpful.

It sounds like you are asking the proper questions, and therefore on your way to deciding to be more healthy, taking charge of your diabetes instead of having your diabetes be in charge of you. Don’t get frustrated with the hard work ahead or beat yourself up too much by what you have not done in the past.

SB