February 18, 2001
Behavior
Question from England:
My daughter was diagnosed with type 1 diabetes two years ago. and has never really been in control. Now, does not want to do the fingerprick tests (she says it hurts too much) and is really depressed. I am very worried because her blood sugars are usually in the range of 13-20 mmol/L [234- 360 mg/dl]. The diabetes team at our nearby hospital do not seem to want to help.
Answer:
It is imperative that your daughter check her blood sugar levels. If she will not do it, then you must. I would advise making an appointment with a psychologist or a counselor familiar with diabetes. Your child may have a phobia that can be treated with behavioral intervention. Her depression also should be assessed by a professional.
CMB
[Editor’s comment: I agree with Craig that your daughter needs professional help. She probably has many reason for not checking blood sugars including not wanting to chastised because they are high. All too often, parents and health care professionals alike place value judgements on blood glucose. By referring to the numbers as “good” and “bad”, children see themselves that way. So, if your daughter’s blood sugar are as “bad” as they appear to be, then she is “bad” as well. It then becomes easier not to have to see the numbers at all.
Your daughter’s difficulty with control might be the result of the treatment plan itself. Her regimen needs to be individualized to fit her lifestyle, including her appetite. Perhaps, it might help to set up a meeting with her diabetes team to explore some of these issues and devise a treatment she can live with. If your local team is not helpful, I would suggest taking her somewhere else to “get a fresh start”. In the meantime, you may wish to take on responsibility for blood sugar checks and injections to alleviate your daughter of this burden.
If the problem with checking blood sugars is truly one of associated pain, there are many new devices available that virtually eliminate this problem. Two of them are the FreeStyle made by Therasense and the One Touch Ultra made by LifeScan.
SS]
