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March 16, 2009


Question from Florida, USA:

My best friend passed away at a very young age, 43. We had been best friends since we were 11 years old. Her daughter was diagnosed with diabetes at the age of six. Since her mother's passing, her father has looked into the pump and has tried everything he can to get her to take better care of herself, but she just doesn't seem to care. I'm not sure if it's because she's a teenager and thinking nothing can or will hurt her, or rebelling at the lose of her mother. However, she sees her dad's toes going black due to having diabetes and he is reaching out for help. He has even asked me to look into juvenile diabetes (type 1) and see if I could handle her and help with her health care. I live 200 miles south of them now, but would do anything for them. Nevertheless, if she were a typical teenager, how could I make her care about herself when she does not? She has asked me to adopt her and I was thinking maybe I could I go there and spend a week and see if she would start to take care of herself before I take her on. Alternatively, her father and I would like her have the pump put in. I know her dad is at a loss and is in tears and I hate seeing him that way, but what can an aunt do? How can I help? I am not as easy on my kids. They all have chores and we all chip in. My "niece" has been spoiled and is messy. That would make me crazy and if she did not eat right or takes care of her diabetes, I would pull my hair out. Any suggestions on what to do with a 15 and a half year old who is totally rebelling?


This young lady is very lucky to have you in her life. Having an adult who loves you and believes in you protects teens from so many difficulties. My concern is that both you and her father believe that she “should” be taking responsibility for her own daily diabetes management tasks (taking insulin, checking blood sugars, etc.). Unfortunately, most teens who have never suffered the trauma and loss your niece has suffered are not able to do these tasks all of the time by themselves in a consistent manner. Teens need a lot of adult supervision and monitoring. Many teens need the adults in their lives to give the insulin to the teen and check the teen’s blood sugars. My other concern is that you and her father seem to hope that an insulin pump will make things easier for your niece. However, pumps require more work and more dedication to taking care of diabetes than injections. It may be helpful for the adults in your niece’s life to take over her diabetes care for a while and, then, with improved control and improved health, begin to negotiate what aspects of the daily regimen she is able to take over. Finally, I strongly recommend seeking counseling for your niece. Finding someone who understands teens with chronic illness is important, and also finding someone who understands the impact of losing a parent. Contacting your local American Diabetes Association, her pediatrician’s office, and her diabetes team’s office are all ways to obtain referral resources.


[Editor’s comment: You and dad should read our web pages on Insulin Pump Therapy to have a better understanding of how theses devices work. You may also benefit by reading some of the previous questions we have answered about Insulin Pumps.