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October 20, 2001

Behavior

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Question from Milford, New Hampshire, USA:

My 14 year old son does not always tells the truth about his care. I think he is altering the date and time when he is not taking care of himself and blaming it on a malfunctioning meter. I am looking for a meter that once you put in the date and time it is permanent and cannot ever be changed. Is there such a meter?

Answer:

From: DTeam Staff

This answer is really from one of our Certified Diabetes Educator nurses who has a 13 year old son with type�1A (autoimmune) diabetes and is our expert on this theme.

There are really two problems that you have to contend with. The first is to try to disentangle the reasons for this behaviour, and you almost certainly need help with this over and above the second issue of what meter to use. If you are lucky enough to have your son looked after by a pediatric diabetes team, then you should begin by talking this over with both a nurse educator and a medical social worker. If this is not the case, you might try to find a nearby CDE with experience with children by calling 1-800-338-3633.

Almost certainly, they will suggest as part of the solution, that you take over for a time doing most of the blood sugars yourself under the guise of ‘giving him a rest’ — i.e., not a confrontation. A new meter won’t solve the issue of making the results inviolate, but it will show your concern for the difficulty.

DOB
Additional comments from Lois Schmidt Finney, diabetes dietitian:

Rather than seeking a meter whose time and date can not be altered, I think it might be time for your family and your son to look at issues with having diabetes and taking care of himself. Is there a counselor on his diabetes team that he could meet with? Creativity with the blood glucose values, insulin doses, etc, is a big challenge for the diabetes team. They cannot help him if he is not being honest. In all reality, I bet the rest of this diabetes team have all seen it and not only in teenagers! So please do not get too angry with him for not being fully truthful. He really needs your support and love what his blood sugar is.

LSF
Additional comments from Craig Broadhurst:

My personal view is that meters can be deadly in the hands of a patient who is not reliable with diabetes management. My advice is to return to regular injections and parental oversight.

CMB
Additional comments from Dr. David Schwartz:

I don’t think I understand. Are you suggesting that your son checks a glucose value on a specific day/date/time, gets a reading, and then changes the day/date/time?

I think a better approach would be not to foster the distrust but get the whole family (not just the teenager) into counseling so that you can dig at the root of the issue, namely (in my perspective of this brief description), parental distrust, child’s poor responsibility towards the illness, and possible parents’ lack of responsibility or input. You should engage and be involved, and not let this teen “fly alone.”

DS