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December 9, 2006

Behavior, Blood Tests and Insulin Injections

Question from Olive Branch, Mississippi, USA:

We have recently found out that our daughter has been lying to us again regarding checking her blood sugars and her blood sugar numbers. Since her diagnosis with type 1 at the age of 10, she had always been very responsible with her diabetes. She had been pumping for about a year and a half now and did really great until she turned 13. After that, she got really lax about checking her sugars and tried to make the missing blood sugars look like there was a meter problem or test strip problem. We believed her because she had never lied to us ever before. Her A1c this past summer was 9.2, which is how we ultimately found out that she’d been lying. She has attended diabetes camp for two summers and the endocrinologist and all those in her clinic who know her sing her praises about what a wonderful teen example she is!

When we finally realized that she was lying, we confronted her about it. She was grounded for a time and we became more vigilant about checking up on her by downloading or looking at her meter and pump more often. She did better for a while and since she is also an athlete and plays varsity volleyball and basketball, we thought that she really understood what she’d been doing to herself by lying. Her most recent A1c result was 8.0 in October so I felt like she was on the right track.

Recently, I found out that she has been lying to us again for at least two or three weeks. We had slacked off checking her meter as often because of work and time issues in our family. And, I really thought she had learned her lesson and would never do it again. Not only has she not been checking her blood sugar very often, but the blood sugars that she has checked were extremely high, 300 mg/dl [16.7 mmol/L] to 500 mg/dl [27.8 mmol/L]. I found out because I asked her for her meter and I could tell that when she handed it to me, she didn’t want me to look at it. Of course, we had another confrontation about it when I saw how little she’d been checking her sugar. She wailed and cried and said how sorry she was and that she wants us to trust her. We told her that if she doesn’t wise up and take better care of herself, we would pull her off the varsity basketball team. She seems to really not want that to happen. She is a very good student and those who know her well would never believe in a million years that she would ever do something like this.

I feel like there must be something deeper going on here but can’t seem to get to the bottom of it. She says that she just got lazy about checking and that she just slowly eases into not checking and when asked if she’s checked, said it was easy just to lie and tell us a number. The other thing she said is that it’s hard to really understand the consequences because nothing bad has ever happened to her before. She has never been hospitalized, not even at diagnosis. She’s never passed out or had a seizure or anything. I think she just feels invincible and wants to be like other teens who don’t have to mess with all this stuff.

I am going to speak with her guidance counselor at school and let her know what my daughter has been doing. I am going to be more vigilant about checking up on her by looking at her meter and pump more often. I am also going to let her endocrinologist know when we see him in December.

What other things should we be doing at home? How can we get her to see the error of her ways? I tried to tell her that it’s not fair to her coach or teammates either when she doesn’t take proper care of herself. But, I’m not sure she really understands or maybe she just doesn’t care. I don’t really know. I just wondered what other advice you might have for us.


From: DTeam Staff

Diabetes is not a normative task like making friends or handing in assignments on time. Therefore, expecting a teenager to be able to assume responsibility for this exhausting disease is setting the child up for failure. The parents should do everything for her when she is in their home. This should not be negotiable.

You may benefit from reading William Polonsky’s book, Diabetes Burnout.


[Editor’s comment: We have answered similar questions about teen Behavior within the past year. In sum, the parent needs to take over the child’s diabetes care until he/she is responsible enough to resume self-care. Please read the relevant questions and answers.