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June 17, 2009

Behavior, Diagnosis and Symptoms

Question from Louisville, Kentucky, USA:

I am 53 years old have had type 1 for 31 years. My 14-year-old niece was just diagnosed with type 1 by her pediatrician. She has been referred to an endocrinologist in the city, but has not yet seen him nor is she on a treatment plan. Her pancreas is still working some, but she had some abnormal blood sugars upon testing. Some of the testing I had never heard of and they probably had to do with antibodies. (Glut Decarb with a result of 47). The doctor said my sister would be contacted by a diabetes nurse educator, scheduled for a hospital stay of 23 hours to put her on insulin. This is all before the endocrinologist is even seen. My sister has a call into him to try and understand why they cannot be seen first. My niece has already screamed out that she "IS NOT TAKING SHOTS." She refuses to discuss anything with anyone. She is rebellious, angry and very upset (crying). Do you have any advice on how to deal with a 14-year-old who is refusing treatment and will not cooperate in any way with this diagnosis? First of all, it is very difficult to be 14. Secondly, her parents have just gone through a divorce and she was already angry with her Mom prior to this diagnosis. It is a nightmare. My sister, her mother, is afraid of needles and said, "I can't give her a shot." I will do anything I can for this child, but do not know how to reach her. My sister brought her to my house yesterday to pick up a new glucometer that I had for her. I am surprised the physician didn't give her one. I am sure the endocrinologist will. When pulling in the driveway, my niece jumped out of the car and ran toward the highway. We got in the car and went after her. She was hiding behind a building when I found her. I hugged her and told her I knew how she was feeling. It is a major life change. I was depressed for a long period of time, but I was very sick with mine. She is verbally abusive to her Mom and will not talk to anyone except her friends on the phone. She's not talking about diabetes. I remember how angry I was and I know it will just take time. I just thought you might have some tips on how to deal with a newly diagnosed teenage girl. She is a beautiful girl, probably just not able to deal well with having anything wrong with her. They say that god doesn't give you any more than you can handle. Sometimes I wonder... I was not diagnosed with type 1 until age 22, but was in ketoacidosis at that time and was immediately put on insulin. I am now disabled due to neuropathic pain. I do not want my niece to ever think this will happen to her. They didn't even have glucometers on the market when I was diagnosed in 1978. My average blood sugar was 400 to 500 mg/dl [22.2 to 27.8 mmol/L] for four years as was determined by my first A1c when the test came out. I've been dealing with one problem after another since I got this awful disease. I am positive about it these days as I am now more mature, of course, at 53. I just want to help this child feel better and take care of herself. I want her to be able to have children, etc. I was not able to and I've missed that in my life. I just have a feeling she is going to be angry for a long, long time.


Your story is heartbreaking and my heart goes out to your niece and her family. She is struggling with many difficult challenges in her life, and to have diabetes come on top of those already difficult things is really overwhelming. She needs to be in a pediatric hospital with a comprehensive and multi-disciplinary diabetes team. While in the hospital, she will get the education and psychosocial support she and her mother need to help her get through this difficult time. Please help her get to the hospital as soon as possible. I would not wait.