My 11 year old niece has had diabetes since she was eight, and she wants to be a normal kid, so she eats what she wants, knowing what it can do. She has been in the hospital several times. She is now wearing a pump and sometimes doesn’t do that right either. What can we tell her that will get her to do this the right way and make her understand?

You may not like the opinion that I give you. Of course children with diabetes want to be “normal kids.” Usually that translates to mean that they don’t want to watch their meal plan or check glucose levels, or take shots, etc. In other words, they don’t want to have diabetes — but they do. While the insulin pump is a very good and flexible way to give insulin, it certainly is not perfect.

If despite this technology, your niece has poor glucose control and still has hospitalizations, and still “eats what she wants” (when she wants), then I would suggest she is not mature enough at age 11 to be given this responsibility. I would think that despite her family’s presumable good efforts, the situation is not optimal and that a parent or other responsible adult needs to “take over” her diabetes for her — like when she was first diagnosed.

I would also strongly consider psychologic intervention (even as a group or family sessions) as I see this type of behavior as self-destructive. Please encourage your niece’s parents to talk with her Diabetes Team!

DS