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December 24, 1999

Behavior

Question from Orange, California, USA:

Our 12 year old son has had diabetes for 11 years. He has chosen diabetes as his weapon for rebellion, and is skipping meals and snacks, and chooses to "forget" to do his insulin. He takes Ultralente and Humalog for the flexibility, but we are at a loss as to how to best communicate to him the importance of controlling his diabetes vs diabetes controlling him. He seems adamant about defying us on any issue regarding diabetes. Can you recommend any strategies or resources to help us help him?

Answer:

The most important advice I can offer you is to seek the advice of a mental health professional who has expertise in working with families of teens with a chronic illness. Your diabetes team should be able to refer you to someone with particular expertise in diabetes.

Other things to consider are:

Most 12 year olds are not emotionally ready to assume all responsibility for their own diabetes regimen. It appears that through his behavior, your son is letting you know this.

Consider giving him a “vacation” from the arguing in your family and from the responsibility for his care by taking it over from him for a few weeks. This means that you watch the clock, check blood sugars, draw and administer insulin, feed him snacks and meals, etc. His only responsibility will be to have his body accessible to you to do these tasks. (If he’s nowhere near you, you can’t give him a shot, etc.)

Let him know that arguing about IDDM care is not fun for you and that you’re sure it’s not fun for him. Ask him what he thinks might make things better. You may be surprised by his answers.

Best wishes, and don’t forget that the most important thing to do is to seek the support of a mental health professional.

JWB