From Louisiana, USA:
My son, now 17, has been at a juvenile state correction center for approximately 6 months. He will be there for another 6 months. He was diagnosed when he was 14. His numbers have been extremely variable since he has been there and his insulin has been adjusted at times, however I just spoke with the infirmary and was told his numbers still get as high as 550 at least once a week. The numbers are high when checked in the evening (4:30 P.M.) before his dinner. The doctor states he is not overly concerned because he feels his numbers sometimes range 160-225 and he feels those are good values for him. When he was home, his doctors felt that was too high. They have ordered an appointment for him with an ophthalmologist to check his vision because the numbers have been high. I also asked if he was on a special diet while there and was told he is supposed to be given a snack at night. Does this sound like "acceptable care" for him and are these fluctuations acceptable?
I do not feel this is acceptable care, and this should be brought before the administration.
The American Diabetes Association has issued a Position Statement entitled Management of Diabetes in Correctional Institutions. These are certainly not being met.
Additional comments from Dr. Deeb:Diabetes care in correctional institutions is usually overseen by physicians with no special training in diabetes. Blood glucose values are often allowed to run higher than recommended by specialists.
Some individuals in correctional institutions will use the diabetes in ways that allow for "special" treatment. One obvious way is to induce hypos. I have been led by correctional physicians to believe part of the reason for higher values is to prevent the hypos.
Original posting 31 Aug 1998
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