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July 20, 2000

Behavior

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My daughter was diagnosed with type 1 diabetes when she was 18 years old. Even though it has been two years, she has not taken control of her diabetes. She lowers required insulin doses, rarely checks her blood sugars, and does not follow her meal plan. It has recently become apparent that her lack of control is partly due to diabetic anorexia. She is reducing insulin to control weight gain. As her mother, I am petrified about the irreversible damage she is doing to her body. I knew, given her age, I had to let her take control herself, but she did not. She records fake blood sugar readings and her doctor won’t tell me the “whole” story as my daughter is an adult. I don’t know what to do or how I can help. She is still in school, lives at home. We had a very good relationship, but it is deteriorating as I can’t have an honest discussion with her about her diabetes. She just gets angry. I tried the empathetic soft approach not asking about her sugars, not commenting when she did or did not eat as she would just explode and her blood sugars would rise because of stress.

Last week was the straw. We loaned her the car to drive to the doctor for her check up. Her doctor did not let her out of the hospital as her blood sugar was 42 mmol (756 mg/dl). I was shocked. How could I let her drive with blood sugars that high? How did we or she not know they were that high? What do I do now? Restrict driving unless she shows me her readings? Since she fakes the results, do I demand to be there when she takes her readings? Obviously, my enforcing these rules will make her angry and resentful and I don’t believe they will get us very far. I can’t continue to watch her do it her way — I am afraid she is slowly killing herself and I can’t watch it any longer. I am scared and don’t know how to help.

Answer:

From: DTeam Staff

Your daughter has an eating disorder and must receive treatment for it. Contact her diabetes team to see if they can refer you to a mental health professional that specializes in eating disorders. You may also ask your primary physician for a referral. Finding a mental health professional that will work with you all as a family will be important, since your daughter is living in your home, and her behavior is affecting everyone in the family.

JWB