I think my friend is making her blood sugars go high to lose weight. The past few weeks when I see her tests, her numbers are always 400-550 mg/dl [22.2-30.6 mmol/L], and she me told previously that she used to do it, but was stopping and she didn’t do it anymore. She’s always been really self conscious of her weight, even though she is not fat at all. Is this going to damage her in the future? Should I even be worried?

Unfortunately, it is quite common for people with diabetes, especially teenage women, to withhold insulin in order to lose weight. It is almost unnecessary to add that this is dangerous and can end up with having to go to hospital in DKA [diabetic ketoacidosis]. The same can be said of sustained blood sugars of over 400 mg/dl [22.2 mmol/L].

Whether this is all true is of course a question, but your friend does seem to be indirectly asking for your help. At the same time, I think that it would be a mistake for you to become involved in trying to disentangle the problem, which may have nothing at all to do with body weight. What you can and should do though and be very insistent about, is to urge your friend as strongly as possible to seek help. Very often the best person to resolve these issues is the medical social worker on the diabetes care team. Obviously, her mother should know about this too, recognising that in these years, this relationship can itself be a problem.

DOB