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July 29, 2001

Other Social Issues, Tight Control

Question from Dallas, Texas, USA:

My 10 year old daughter has had type 1 diabetes for nine months. Since her mother and I live in the same city, we split custody (and have for the last six years). The problem is when she is with her mother, her blood counts spike. On a normal day, my daughter is given three shots a day and blood glucose check four times. Her mother does not seem to grasp the need to keep my daughter's meal times on a schedule. She lets her have a burger and fries (usually 100 carbs) for a "treat". When she is with her mother, her blood count seems to run between 150 and 350 mg/dl [8.3 and 19.4 mmol/L]. What will happen if her blood count keeps spiking like that? How long will it take for serious irreparable damage begins happening in her body? I need some facts because even with my daughter's diabetes team talking to her mother, she continues to not grasp the seriousness. Perhaps, it's because she can't see any outward physical damage happening to my daughter yet. However, my daughter does sleep a lot.

Answer:

You have a situation that may be nothing but which may grow to be a large problem. I don’t know how well you and your child’s mother get along but I strongly suggest that, together, you visit with your daughter’s diabetes team. This way, there is less chance of poor communication. Relay your concerns to your ex and the team members.

Periodic glucose “spikes”, unassociated with ketones, are probably not harmful in the short-term. However, if they are reflected by ongoing higher hemoglobin A1c values, then risks of complications will rise as well.

I am fearful that this will be a matter of “he-said/she-said” and distrust and resentment in the two households and that your daughter will be in the middle.

DS