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August 11, 1999

Behavior

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Question from Florida, USA:

My 14 year old daughter was diagnosed with type 1 diabetes 3 years ago. She has intermittent bouts of non-compliance. This past week, she was in the ER for ketoacidosis. When she became symptomatic with vomiting and dehydration, I asked her to test and she replied with a reading which was in normal ranges, numerous times, so I assumed she had intestinal virus. I checked her monitor 3 hours later and discovered that she hadn’t tested for over a week and was making up readings the entire time. Actual test then was too high for monitor to read. She has changed time and dates to make it look like she has tested in the past. We don’t have money for counseling, have insurance but pays very minimal for counseling.

How long should I have to watch her test and bolus? I cannot trust her right now. I have to work and feel overwhelmed. Is there any service to assist with counseling for children with chronic illness? I am at my breaking point and cannot get any answers for therapy. Her A1C’s are wonderful (5-7) because I stay after her reminding her and asking for numbers everyday. Now that she is lying and making up numbers I feel she needs help. She has been educated well about complications. She seems to resent me for having to stay on her all the time and asks that I back off, but as soon as I do she is irresponsible. I don’t want to accept what I hear about this being normal behavior for her age. I cannot afford frequent trips to the hospital. Seems like if you are working and middle class with insurance there aren’t any sources of help!

Answer:

From: DTeam Staff

I completely understand your level of frustration. You mentioned your daughter “bolusing”: is she on an insulin pump? One of the mandates for pump management is maturity and a strong ethic around blood glucose monitoring. She does not meet those criteria by your report. This could be very dangerous.

If she is not on a pump and I misunderstood your post, she is still putting herself in danger. Oppositional behaviors at 14 are taxing but normal. (I know you did not want to hear that again!)

Counseling is not a luxury, it is a necessity. It does not have to be costly. Persist until you find someone willing and trained to walk with you and your child through this bumpy time. Do not give up.

CMB