Our daughter is 15 and was diagnosed at age 11. This year she has decided to stop taking care of herself. Her A1C’s have been over 13 for the last nine months. Her doctor and diabetes educator both believe my daughter needs to get through her rebellion before she will take care of herself. She tells us that not taking care has no consequences except that she feels like she has no diabetes, whereas control requires a lot of work and symptoms she hates (low blood sugar occasionally). I want her to be put into the hospital to re-learn management and get a team of help (doctor, therapist, dietitian). Our doctor does not have a large adolescent population so I have no other situation to compare this to and I feel like I am losing this battle. Is this common in teens and what is the best way to solve this?

It sounds as if your daughter is burned out by the demands of the diabetes regimen. This is not uncommon in teens, especially if they have been handling the responsibility for the daily diabetes care demands on their own. Right now, your daughter is unable to manage this responsibility. Therefore, you must take over all aspects of her diabetes regimen. She does not get the choice of missing shots and missing blood checks, as this is not a safe choice — and as her parent, you can not stand by and watch her do things that are dangerous without intervening.

Her burnout is not something she will just “get through”, even after you take over the diabetes care tasks, unless she receives counseling to help her learn effective strategies to use to handle the ups and downs of living with a chronic illness. Hospitalization for re-education is usually not helpful, as burnout does not occur because of lack of knowledge, but because of the emotional burden of living with diabetes. Call your local ADA and JDF offices to see if there is a psychologist or other mental health professional in your area who is expert at working with teenagers with diabetes and their families. You and your doctor might also check with the diabetes teams at nearby major Medical Schools or Children’s Hospitals.

JWB