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April 10, 2005

Behavior, Daily Care

Question from Signal Mountain,Tennessee, USA:

My 19 year old daughter refuses to take care of her diabetes. She no longer tests her blood or gives herself insulin to cover the food she eats. She does one dose of Lantus in the morning and that’s it. She refuses to discuss the matter with me and recently has refused to see her doctor. What do I do now?


From: DTeam Staff

You have asked a difficult question. I wonder why your daughter is now refusing to check her blood sugars and refusing to take short acting insulin when she eats. Is she burned out from diabetes? Is she depressed? Is she trying to manipulate insulin because she is worried about her weight? Will she let you take over any or all of the diabetes management tasks when she is home? Maybe you could give her the insulin and check her blood sugar. Another idea is whether she should be on a more simplified insulin regimen, like two shots of mixed insulin, so she wouldn’t have to worry about taking insulin every time she eats. However to switch insulin regimens she would need to meet with a health care provider. Is there anyone else that she is willing to meet with besides her current doctor? Would she meet with another doctor or another certified diabetes educator (CDE) and you could arrange the appointments? I am also wondering if she would be willing to meet with a counselor (psychologist or social worker) to discuss how she is feeling. This is a tricky situation because she is over 18 and she is an adult. Do not give up though, even though you said that she is refusing to discuss certain things with you and refusing to see her current doctor. Hopefully, she will open up more and let you help with some diabetes tasks or at least be willing to meet with another health care provider.