June 6, 2003
Behavior, Insulin Pumps
Question from Louisville, Kentucky, USA:
My 15 year old son who is on an insulin pump is completely noncompliant with his diabetes management. He will disconnect his pump, refuse to start new sites when needed, and I am constantly battling with him to test. I am lucky to get him to test once per day, his average blood sugar is 250-350 mg/dl [13.9-19.4 mmol/L], and he has been hospitalized twice in the last six months for DKA [diabetic ketoacidosis]. He is spilling protein into his urine, so I know this is causing additional problems.
I have worked with his endocrinologist who has spoken with him. He’ll agree to make changes, but once out of the office, we are back at square one. She recommended counselling, which we tried but that made things much worse. Do you have any other suggestions to counteract this rebellion of sorts? Any help you can provide will be greatly appreciated.
Answer:
This behavior can be life threatening. I strongly advise taking your son off the insulin pump and returning to injections and routine blood sugar testing. These should be done by a parent if he is still rebelling. Pumps are meant for responsible patients and not for careless or reckless persons. If a period on injections can restore stable behavior, then the pump can be revisited.
CMB
