My 10 year old daughter has had Type 1 diabetes since she was 8. She is in full blown puberty and her levels have been high, but her doctor said they would be hard to control for about 2-3 years until she gets through puberty. Last evening, she didn’t want me to watch her do her dinner shot. We found out that she has been giving herself almost twice the amount we tell her to do. She said she was afraid because her sugars are so high all the time. I talked to her but don’t know if I got through to her. What do we do?

Your daughter needs help. She is on a very dangerous roller coaster where she might over treat lows and then over-treat highs and constantly bounce back and forth. This will cause her to feel awful, moody and as if she has no control over her body.

You can help her in two ways. First, let her know that diabetes is not a “do it yourself” disease, and that you will be giving her the blood checks and shots for a while so she can take a break from the stress of the blood sugar roller coaster. Second, find a mental health professional who works with teens with diabetes (your diabetes team and/or your local ADA or JDF should be helpful with referrals), and schedule an appointment for your family as soon as possible.

JWB
Additional comments from Stephanie Schwartz, diabetes nurse specialist:

It is true that blood sugar levels are higher during puberty. However, they don’t necessarily need to stay that way. Insulin requirements can be 2-3 times what they were before. I suspect that she may also be eating more than her current meal plan which is a normal phenomenon of puberty.

If she’s not on an intensive regimen with multiple injections or an insulin pump currently, I would talk with her diabetes team about getting her on one. An intensive insulin regimen will allow her to eat like other girls her age; she can adjust her doses based on what she wants to eat or has eaten (if using Humalog). An insulin pump provides the most flexibility and means of “fine tuning” insulin at times of the day when hormones are peaking. I would discuss these possibilities with both your daughter and your diabetes team. If your current diabetes team cannot offer such options, and chooses to settle for poor control, find yourself another team specializing in the care of adolescents with diabetes.

SS