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August 31, 2000

Daily Care

Question from Arlington, Texas, USA:

I am 32 years old and went on an insulin pump last autumn. I had gestational diabetes with my nine year old son. When he was two years old, I developed type 1. Every since he can remember, I have had diabetes. My 14 year old son developed severe hypoglycemia when he was eight years old. Both of my children are in the Diabetes Preventative Trial because they are at high risk. Individuals at high risk are tested once per year or once per every two years for Islet Cell Antibodies. Both of my children have always tested negative. Last winter, I discovered my nine year old had symptoms of diabetes and elevated blood sugars. We scheduled a four hour GTT and within thirty minutes his blood glucose was 362 mg/dl [20.1 mmol/L]. We rushed him to the children's hospital, and, at that time, I requested the islet cell antibody screening and to have it forwarded appropriately. We are now awaiting the test results. Needless to say, I am outraged at parents that choose not to personally monitor and supervise (or perform) the glucose monitoring, dietary needs and insulin injections for their children. When an individual chooses to have children, they volunteer for such mandatory duties as this. No one wants to believe that these things will happen to our children, but when they do, they should be responsible enough to take control of the situation -- before the situation takes their child's life! In the same sense, we may not always be available when he needs insulin, and he needs to be able to administer his own injections. (This is an occasional situation; he is only nine years old.) For example, if he is spending the night with a friend and he needs his bedtime or early morning injection, then he needs to be comfortable enough to administer his own shot. This is co-managing his diabetes. I am sure that I have stepped on a few toes. If I have offended anyone, then perhaps you need to step back and evaluate your priorities. Is your child's life more important than your "freedom and convenience" of him/her self-managing their diabetes?! How many parents out there actually accept the "inconvenience" and manage or co-manage their children's diabetes?


The vast majority of parents in our practice manage or comanage their child’s diabetes. We see 600 kids with diabetes in our clinic. Very occasionally we have parents who can’t or won’t take care of their children and we report them to Child Protective Services. Most cases are resolved. Some kids are placed in foster care. These cases are very rare.


[Editor’s comment: I agree with Heather that most parents do successfully co-manage diabetes with their children (and with their medical team). Thank you for pointing out the importance of this issue. Comanaging is developing a partnership, where the parent is initially the “senior partner”, then gradually transfers responsibility more-and-more to the “junior partner” (the child with diabetes).

Finally, you should request that both your children also have the GAD antibody, which is not done as part of the DPT study protocol.