My daughter was diagnosed with diabetes at the age of 8; she is now 14. She is being seen by a doctor and mental health professionals for depression. Our problem is that our daughter refuses to take care of herself. She sneaks food, does not do shots on time, and lies to us (her parents) about taking them. This behavior has been going on for several years. We have tried diabetes education classes and a number of other alternatives including admission to a mental health facility, but we keep ending up with her diabetes getting out of control and being admitted to hospitals. Do you have any other advice we could try to change this child’s behavior in dealing with her disease?

I hate to sound like a broken record, but age 14 is the worst age for kids with diabetes. So many times “the wheels come off” around this time and I have received numerous questions from parents who feel as frustrated as you. Part of the problem is that a child’s developmental task is to break free from their parents around this age. However, in the case of your daughter, the rebellion has taken on some life threatening dimensions. Out of control diabetes, DKA, hospitalizations, and psychiatric interventions have been unsuccessful. Your daughter’s depression (is she on medication for it?) makes it imperative for the adults around her to pay close attention. Does she want to survive? Is her self esteem at such a low level that she may do herself harm?

I am not there. I do not know all the complicating factors. I do not know what her life with diabetes has been like since diagnosis. I urge you to enlist the services of someone who has in depth experience with both diabetes, and Mental Health in children. There aren’t many of us around but we do exist.

My strong concern is the level of your daughter’s depression. I know of cases where depression in teens was minimized with dire consequences. Please have her evaluated and often; have the clinician try newer antidepressants or dosage changes. If she is endangering herself, it is a message! The message may be anger, sadness, or just an inability to cope with her condition. Never quit looking for “the right match” in a therapist. There is someone perfectly suited to help your child out there. Keep asking, keep looking and keep her safe.

CMB