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November 21, 2008

Behavior, Mental Health

Question from West Chester, Pennsylvania, USA:

My daughter and our family have been dealing with type 1 diabetes since 1996. My daughter is now in high school and has no control over her diabetes. She forgets to check her blood sugar and forgets to give herself insulin for lunch/snack/correction. She always complains of not feeling well, but refuses to make a connection to her blood sugar control. After 14 years of monitoring her closely between home and school, I'm frantic about how to proceed with her care. We're close to her wanting to drive and planning to go off to college. How do I stop this train wreck?


It is likely that your daughter is struggling with “diabetes burnout,” which often happens to people who become exhausted by the never-ending burden of the daily demands of diabetes. Diabetes Burnout by William Polonsky, published through the American Diabetes Association, may help you and your daughter understand what she is going through. In addition to reading this book, I would encourage you to take over your daughter’s diabetes regimen, at least for a few weeks. Check her blood sugars and administer her insulin. That will give her a bit of a “break” from the daily tasks while her body becomes healthier by getting the amount of insulin she needs. Finally, I’d encourage you to contact your diabetes team, her pediatrician, and your local ADA office to obtain referrals for a mental health professional with expertise in working with teens with diabetes.