June 19, 2000
Question from Liverpool, Merseyside, England:
My 16 year old daughter, who has had diabetes for 6 years now and thinks she knows it all, is lazy on the weekend and won’t get out of bed, which messes up her control. She has been in hospital 3 times this school year with ketoacidosis, but it may be due to exam stress. I want to know what to do when she stays in bed and I have to go to work.
It may not give you any comfort but your daughter is behaving normally. Teenagers all like to lie around in bed and it is entirely aberrant for them to be up with the lark on Saturdays and Sundays to eat at regular intervals and to comply with any kind of regimen. This, of course, doesn’t help you much but it may make the point that your daughter will get through this phase. The trick is to try to achieve this nirvana without her coming to any harm.
Many teenagers do not take their insulin regularly and this is the principal reason for recurrent bouts of ketoacidosis. Therefore, the most important message is to try to ensure that she gets most of the insulin she’s supposed to have. Blood sugar testing, coupled with urine ketone testing and judicious use of extra insulin, can prevent ketoacidosis.
Additional comments from Jeff Hitchcock, The Editor:
While it is true that tight blood control is a challenge for many teens, the fact remains that frequent blood glucose testing is the foundation of blood glucose control. Sleeping in may be an area for compromise, but blood glucose testing and taking insulin should never be open to debate.