My 15 year old daughter has had “brittle diabetes” for 6 years now. Her blood sugars are erratic because her eating is out of control. It is getting so bad that she has been caught stealing candy in the store. I have to watch her take her blood sugar each time because she lies about it. Her doctor, nurses, counselor, friends, and family have all tried to make her see that she is hurting herself, but she has this “it won’t happen to me” attitude. It’s like food is her “drug” of choice and her addiction is so bad that her entire life revolves around it. Are there special places to send teens with diabetes who are way out of control to teach them how to deal with this?

You are right to be so concerned about your daughter. She is doing things that are very dangerous. One thing you can do for her is to totally take control over all of her blood sugar checks and all of her insulin shots. That way, the only thing she is responsible for is her food intake. Although she may be out of control with her food choices, at least that would be the only erratic variable in her day, and might help you and your diabetes team figure out some effective strategies for helping her.

As far as programs for your daughter, there are none that I know of that would specifically address the concerns you raise. Her biggest problem is her disordered eating, so you need to call your diabetes team and your pediatrician and find out what mental health professionals in your community work with teens with eating disorders. You can also call your local American Diabetes Association or local Juvenile Diabetes Foundation to see if they recommend any psychologists or other mental health professionals in your community with expertise in teens and diabetes, although her eating disorder should be the main focus of treatment.

JWB
Additional comments from Stephanie Schwartz, diabetes nurse specialist:

It may be that she is hungry. Make sure she sees a dietitian and tells that person how much and what she would like to eat. Perhaps, her treatment plan could be changed to allow her more freedom with her meal plan. An intensive insulin regimen or a pump could very well be of benefit in that she would then be able to take insulin after meals and match her dose to what she has eaten. Trying to get her to “comply” with something she is having difficulty living with will never work. You, and her diabetes team, need to discuss treatment options with your daughter and find a program that matches her lifestyle.

SS
Additional comments from Lois Schmidt Finney, diabetes dietitian:

I think it would be best to see a diabetes team and consult with a dietitian who will assure the family that there are no bad foods, just foods that should be consumed in a limited quantity. I really don’t think this situation is as bad as it sounds, she just needs a caring team who can help her see that a small candy bar is okay, as long as it is worked in to the meal plan. Also, a consult with a social worker/psychologist is recommended.

LSF