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February 25, 2002


Question from Baltimore, Maryland, USA:

I work with a 14 year old girl with brittle type 1 diabetes who continues to have high blood sugar readings. She has found innovative ways to manipulate her meter to misread her level, which then effects the amount of insulin she receives. Other teenage issues are arising, and the parent is having a lot of difficulty seeing any positive traits while the child continues to manipulate and lie about sneaking. I don't know if I'm seeking some advice to help the parent or asking for some encouraging words, but both would help.


You do not mention the kind of work you do with this 14 year old girl. Are you a teacher? Coach? Counselor? It sounds as if this young lady is struggling with more than her diabetes, and not feeling particularly successful in any area of her life. How sad for her! No matter what role you play in her life, she is certainly lucky to have someone who cares about her.

It might be helpful for you to have her teach you about diabetes. This might help you better understand what she knows and does not know. It might also be helpful to then ask her all kinds of “what if” questions to understand her problem-solving skills more.

There are a number of excellent mental health professionals in your city who specialize in working with people who have diabetes. You may wish to contact your local American Diabetes Association for a list of referrals. Finally, you may benefit from reading Practical Psychology for Diabetes Clinicians: How to Deal With the Key Behavioral Issues Faced by Patients and Health-Care Teams by Barbara Anderson and Richard Rubin.