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January 18, 2001


Question from San Diego, California, USA:

My 16 year old daughter has had type 1 diabetes since she was 13 months old. Simply put, she is tired of doing good management. She is sloppy with her diet limits, will not count carbs, and is less timely with giving her insulin before or close to eating her meals. Her last two HbA1c results were around 10 and 11%. Her endocrinologist and I are concerned. What can I do to help move her out of this place of complacency? We have tried informing her of the possible complications, but you know how teenagers think -- they're indestructible!


It is not at all unusual for teenagers to begin to feel overwhelmed by the burden of the daily demands of living with diabetes. This is often true for teens who have been doing most of their daily care by themselves for a while. It is usually very helpful to talk openly with your daughter about what you see, and about your concerns (without threats of future complications, and without implications that you are disappointed in her). Ask her what she thinks might be helpful right now. For example, many teens need a break from the demands of their diabetes care, and they can get that “break” by having their parents take over all blood checks and all shots for a few weeks. Parents can also make snacks and lunches for their kids to take with them, so that they can even get a break from carbohydrate counting. Once teens have had such a “vacation” from the cognitive and emotional burden of diabetes, they often feel re-energized and want to take back the responsibilities for this demanding daily regimen.

You may also find a lot of help from members of your daughter’s diabetes team. I’m sure they have seen many, many teens like her over the years. Finally, if your daughter does not begin to feel better soon, and if her interest in self-care does not improve, then you should ask your team for a referral for a mental health professional with expertise in working with teens with diabetes.