Going backwards

My teen daughter’s A1C has been climbing. Her BG averages 200. Most of the highs are at night because she stays up late and snacks. I have no idea if she boluses or even checks before she eats a sandwich or bowl of cereal. I have no idea how to motivate her to be careful or how to get her to watch what she eats. She refuses to bolus before meals because she doesn’t know how much she will eat and this causes her BG to spike. She also refuses to wear her CGM which would make control easier. When I remind her to test and bolus she acts insulted and says she isn’t an idiot.

Any advice please?

She’s not doing this out of lack of knowledge, it’s about control and rebellion. Telling her to be responsible isn’t going to work.

I hope this isn’t the case, but I used to do the same thing and I have struggled for a lot of years with eating disorders related to my diabetes. Girls with diabetes are twice as likely to develop eating disorders as non-diabetic girls. http://spectrum.diabetesjournals.org/content/15/2/106.full

As a child I’d go to the corner store and get all the candy I wasn’t supposed to have (this was a long time ago, back when diabetics had really restrictive diets). As a teen I’d wait until my parents went to bed and then sneak food. If I didn’t bolus for it I didn’t gain weight. My parents half-heartedly tried to address it, but didn’t really understand that my eating was a way to rebel against years of dietary scrutiny. As a young adult I bounced between starving myself and binging on candy and junk food.

Again, I hope your daughter isn’t dealing with an eating disorder. I hope she’s just hungry for a midnight snack. But I think you should speak with her about it and make sure.

Don’t expect her to be a textbook diabetic. Choose your battle carefully. Be happy that she’s taking insulin and try not to make a big deal about her bolusing after eating. Yes, it would be ideal to do it before a meal, but most diabetics bolus after and the world doesn’t end. Occasional blood sugars in the 200’s are not the end of the world. If your diabetic child survives through his or her teen years without being hospitalized for DKA, you have done well.

Also, read this post from another mom. You are not alone in dealing with a diabetic teen. Try not to have unrealistic expectations of your daughter. Just because she has a serious disease doesn’t mean she won’t be a dopey teenager. http://www.diabetesmine.com/2010/02/teens-with-diabete.html

I have to say that I can relate to the not bolusing before meals. I also never knew how much I would eat. Luckily, by bolusing after the meal, my digestion matched well with the insulin. Don’t forget that this is a huge, adult responsibility being born by a child. Do everything you can to take some of the weight off her shoulders. Do you know how to count the carbs? You could consult with her (help her feel smart) on how many carbs you both think she has eaten. Do the math with her to calculate the bolus. When she tests in your presence, have your own lancet and stab your own finger. That way she won’t feel so along. That’s my suggestion to help her a bit anyway.

Hi I agree with Jenna I think she doing out rebellion. I know I did when was teen I would eat candy, I even had hiding spots for candy so my parents wouldn’t find it. The other thing is being diabetic as teen is really I know I struggle as an adult it. I think the other is as a kid you think nothing bad will happen. I sometimes bolus after meals because I don’t know how much I’m going to eat. Is she on a pump or shots? What I would do just not nag at her I know this hard to not do, but if she is taking insulin and checking sugars it’s better then some diabetic. I know when I was a teen I never tested.

From my experience, I was only testing at most twice a day and rarely bolusing when I was a teenager. I did it more because I wanted a break from having diabetes. What you need to remember is that diabetes is notan easy diagnosis to work with. There will be times when your numbers are high, times when your numbers are low and times when they are right in range. It is an ongoing battle to find balance.