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From Laurel, Maryland, USA:

My 17 year old son was diagnosed three years ago with type 1. He is very athletic, but gave up his fall and winter sports this year. The past four to five months, he has become very lax in controlling his sugar levels, testing only once a day, eating without taking injections, etc. Because of this, his sugar levels are extremely high for the past 30 some days. He appears to be giving up. What do I do? Nothing I do seems to help any longer. It only seems to make him more angry.


As you know, managing diabetes during adolescence is extremely challenging. In addition to the physiological challenges, there are also the emotional and developmental challenges of adolescence. Therefore, it is common for teenagers to get burned out from diabetes management. I wonder if your son is burned out from diabetes management? Will he let you take over any of the diabetes tasks when you are both at home? Will he let you check his blood sugar or give him his insulin whenever he is home?

I would also recommend that you talk to his health care team about this if you haven't already. They may be able to give you both some suggestions as well. Maybe he needs to be on a more simple insulin regimen for now. Also, do you know why he isn't playing sports anymore? Does it have anything to do with his diabetes? High blood sugars can negatively impact athletic performance.

I also wonder if he is feeling depressed. Individuals with diabetes have a higher risk of being depressed than individuals without diabetes. So, I would recommend that he meet with a counselor (psychologist or social worker) to assess for depression and to talk about how he is feeling. Your son's diabetes health care team may be able to refer you to a mental health clinician that is also knowledgeable about diabetes.


Additional comments from Dr. Marco Songini:

It may depend very likely on the non-acceptance phase of the different four or fives phases of the psychological crisis that an adolescent has to pass, after the initial diagnosis, towards the active full adjustment to the disease. I suggest you to talk to a diabetes team involved in the care of adolescents with type 1 diabetes where a psychologist might work with your son to help him to develop the right attitude to cope with the disease.


Original posting 14 Mar 2005
Posted to Behavior and Daily Care


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