My daughter currently lives with her father and stepmother. When she was living with me, her doctor wanted her levels at about 150 mg/dl [8.3 mmol/L], but no more then 180 mg/dl [10.0 mmol/L]. Now, her stepmother has them out of control. She seems think it is necessary to keep her levels higher at night. If my daughter is 200 mg/dl [11.1 mmol/L] or under, she wakes her up and gives her a snack with sugar. Consequently, her levels are running way too high. The only time she has normal levels is in the morning, then, with all the food she gives her, she runs anywhere from 200 mg/dl (11.1 mmol/L] to over 400 mg/dl [22.2 mmol/L]. My daughter is now having vision problems, which I believe are a result of her high sugar levels. How do I make her understand she is trying to keep her levels too high, which, in the long run, is damaging my daughter?

This can easily explode with both households fighting and bringing up other issues that may not really pertain to the child. As a gentle reminder, this is not just a “stepmother” issue; the girl’s father has a responsibility here, too.

The child’s interest needs to be put first. I’d wager that the stepmother is not trying to undermine the girl’s health deliberately; rather, she is likely really afraid of hypoglycemia and possible serious, scary consequences of that, such as hypoglycemic seizures.

I’d suggest that ALL of you meet together with your daughter’s diabetes team, especially the education team, to see what can be done to address the issues. If, after some of these sessions you really feel that your daughter is not getting proper attention and is thus in danger, you may then have to see how you can get increased custodial rights or contact social services. Try to put aside differences with your former spouse and his wife and be your daughter’s advocate with the help of her medical professionals first.

DS