College Freshman A1C 14+

My daughter is 18, a T1D, a college freshman living in the dorm not far from home. She was diagnosed in June 2008. Her diabetes was well under control until she turned 18 and stopped taking her insulin. She won't agree to allow her parents to know about her health or school, using the HIPPA law as her protection. She had an insulin pump which she has since stopped using, just injecting insulin now. Since she turned 18, she's lost 30 lbs (now a size 3). Her A1C is over 14, where it has been since at least last fall. And she continually lied to us about checking her BG and taking her insulin.   When her A1C was discovered to be so high, she was put in the hospital for 3 days in December. She messed up her first semester, ending on academic probation with a GPA of 0.2. And this is a scholarship student! She talked her way back into school, but if she screws up again I am sure they will move to dismiss her.  She has a therapist and a psychiatrist who prescribes anti-depressants for her, but they haven't helped in our relationship. The medical bills I have now because she won't take her insulin is over $2,000, money I had put away to pay for her tuition next fall.  Her dad and I told her that if she doesn't get her diabetes under control, we would not support her going back to the dorm next year. Well, that's exactly where we are now.

For an otherwise intelligent young woman, she's behaving stupidly, putting her health in jeopardy. She's completely freaking out, and I don't know how to repair the situation.  Her doctors told me they want her to check in to a rehab facility for 4-6 weeks to get her diabetes under control and figure out why she's sabotaging herself so badly. But she doesn't want to go, and our insurance won't cover it. Anybody have any suggestions? 

I am so sorry you are dealing with this. Has she discussed any reasons why she is withholding insulin? Is it for the purpose of weight loss? It sounds like she may have diabulimia, but it could be any number of things. As a type 1 who also had an eating disorder, (and have now been through recovery and have an A1C of 6.1), I can say that she's clearly struggling a lot right now (as is obvious to you). 

While she is 18, if it's clear she's unable to make decision for herself, you, as her parents, have defacto Power of Attorney and can make those decisions for her. However, it would likely mean she would need to be in an inpatient facility and admitted against her will. Will your insurance cover even a short term stay in a psychiatric unit associated with a normal hospital (as opposed to a 'rehab' facility)? It seems that her healthcare providers are willing to take that route if necessary. 

I found this website for diabulimics, which also says they have an individual who can help you push for insurance coverage. It's worth checking out:

I hope at least some of this info is helpful! 

Hi, I'm finishing up my freshman year in college, and I have T1 diabetes.  My first semester, I ignored my diabetes pretty badly, and when my parents would ask me how I was doing, I would say everything was fine. I was eating foods that weren't okay for me to eat, I wasn't taking my insulin, and I stopped checking my sugars. Over winter break I went in to my doctors for an A1c, and it came back very high.  I also had problems with depression, and I think that is just one of the symptoms of prolonged high blood sugar.  It's hard going into a new environment and learning how to cope with a disease that is with you 24/7.

My parents said I couldn't go back to college if I didn't get my A1c down and my diabetes under control.  I was really upset with my parents, and I didn't want to have to drop out of school, or live at home.   I know that I was able to manage my diabetes much better when I was living at home, and it definitly helped being around my family who knew about diabetes and understood.

I really hope that your daughter gets better!  I'm not really certain what suggestions to offer, but I thought I would share my story with you, since I was down a similar path last semester; my doctor told me that I was definitely not the first diabetic to screw up Freshman year. So she's not alone, but I do hope she gets better and understands how important it is to take care of oneself.  

I hope I helped in some way!  

Thanks for your input, Molly. Since we don't know any other diabetics, your posting is a revelation! Best...