Teenage girl who won't check herself & give insulin, etc

so my 16 year old girl. now won’t check her self when she need to she did pass out from her bg being so low. & she won’t treat when she need to. or give her self when she need to Insulin. i just don’t know what to do. she just being a pain.

In light of the fact that she was recently diagnosed and is 16 (an age that I recall as a living hell even without T1D in the picture!), she is likely feeling very angry about the loss of control that diabetes is causing in her life. It’s counterintuitive, but I suspect that her not performing the necessary diabetes “chores” is her way of trying to take back the control that T1D took away from her. But I hear you, Amanda, her current behavior is undoubtedly a source of major pain and worry for you!

The most important thing is to keep her safe. And if that means your daughter having to go to the nurse’s office in between every class (or however often you decide is appropriate) to have the nurse or nursing assistant or whoever supervise her checking her blood sugar and taking an appropriate correction dose of insulin or treating a low blood sugar and waiting an adequate amount of time and then re-checking her blood sugar, then that’s the way it has to be. If she finds this plan not to her liking, then she can earn the privilege of not having to go to the nurse’s office by checking her BG level by herself the appropriate number of times per day without going to the nurse’s office (to be verified by checking her meter after she gets home from school.) I realize this sounds kind of harsh, but sometimes “tough love” is the way to go. You can present it to her in a manner that emphasizes how important it is to take care of her T1D and how you want her to remain healthy and complication-free.

Another suggestion: my daughter has a “comprehensive diabetes treatment team” that includes a psychologist who specializes in children and adolescents with T1D. Is there someone like this available who can speak with your daughter?

One more thought: my daughter is only 13, “going on 14” (and is celebrating her 2nd Diaversary this coming Sunday), but she would be happy to connect with your daughter and listen to her vent. (And I’m certain my daughter would love to do a little venting herself about what a pain-in-the-a$$ nag I am when it comes to reminding her to pre-bolus, calibrate her Dexcom, stop ignoring her Dexcom alarms and correct her highs, stop SWAG-ing so often and actually count the damned carbs, etc., etc.) Just PM me if your daughter is interested, and we can figure out how to put our daughters in touch with each other.

Hang in there, Amanda!


i did ask her school nurse to check in on her at ever class. & for her to go to her office in between every class. & so far it works out good. today was the 1st day of her going to her office in between every class & me checking her meter after she gets home. she did miss most of school today due to her being to high. & i do have a appt on Tuesday for her to see a psychologist.

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I was 17 when DX’d and angry. I suggest a bit of a different approach then you are taking, (not that it is a bad approach, I am not being critical). I suggest you schedule and make sure she attends therapy. I suggest this because, I feel strongly that if my parents had gotten me to therapy my life (the next 20 or so years anyway) would have been far better.

Remember, your daughter has suffered a perceived loss). A loss of freedom mostly. When I suffered that same loss I held it in, it was not productive. That is where therapy can help. Reconciling the perception of loss and the reality of life with diabetes can be difficult. Even if she is not ready for therapy you can give her a gift of letting her know it is OK to seek professional help sometime in the future when she is ready.

I wish her and you the very best.



Its all about being in optimal / normalized Blood sugar range and due to her age - may be freedom in life style

If all that this guy blogged about is true, Afrezza for Meal time, Tresiba for Basal and Freestyle by Libre would give your teen age daughter the encouragment / hope she needs to avoid the complications of high sugar



For a teenager, I think the issue is most of all about not wanting to be singled out as different, peculiar, abnormal in some way. So being hit with a T1 diagnosis feels like the realization of your worst anxiety dreams. It’s hard to remember as adults how devastating those feelings are, but to a teenager they far outweigh rational concerns about long-term complications and whatnot. All this testing and injecting and dealing with hypos just signifies you’re not like the other kids, not normal. If there’s some way to help her get in touch with other young people with T1, without making her feel like she’s being forced to join the Special Kids’ Club, that’s probably the best thing you can do for her emotional well-being. Knowing you’re not alone, and there’s nothing weird about you just because you have this extra thing in your life to deal with, is crucial.

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i do tell her all the time there is nothing wrong with getting professional help. i tell her that her Brother go to therapy. but i do think her getting therapy will help. right now i just want her to get better. & do her diabetes “chores”

you’re Mum/Mom and harping will only make it worse. you would both be better having a cuddle and a cry over how T1 sucks and it’s not fair.
sometime the best thing you can do is step back and just be mum

is she seeing just a Dr or is it a diabetic clinic, nurse or team. they deal with this stuff every day.
getting her on to the facebook teen groups would help too,

it could be that she tried, her BG all over the place because of teen hormones, got frustrated and gave up. it’s also hard having the meter tell you if you pass or fail 10 times a day. it’s hard to see it as just a number that help with insulin doses.

Or with the not taking insulin. could it be the weight issue for teens? Is she on a fixed dose mixed insulin? when first DX they tend to set that high because most are skinny when DX, to make them hungry and bulk up to healthy weight again. They don’t know that if they don’t eat many carbs, they need a lot less insulin. more carb=more insulin=more weight.
LCHF may help her realise that she is in control of her weight if that’s an issue. It will also help stabilize her BG levels

and later Dr. Bernstein’s book diabetic solutions is very good, along with another, think like a pancreas

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For some reason I don’t see a LCHF as being likely to be very productive for a non-treating teenager. The big barrier for people in that situation is to get people interested in taking care of themselves. Which is sort of why I disagree with articles suggesting things like “you can’t control diabetes…” as I have found it very important to think that I can control diabetes so I will keep doing things that ill increase my chances of doing it more often than not.

I think securing assistance from the school officials and also a counselor are both excellent ideas. Involving a 3rd party (who may say exactly what the parents have been saying…) can work to leverage things into a teenager who thinks they know everything.


Just my 2 cents on LCHF and growing children/teens: NOT a good mix. I personally don’t think growing young people should eat a LC diet. And if Amanda’s daughter is angry and resenting the control and “normalcy” that T1D has recently stolen from her, the last thing she needs is a radical change to a diet that is likely very different from her peers.

(jack16, I know you had nothing but the best of intentions, and I do not mean to sound harsh…)

That’s ok, I don’t take offence. there can never be total agreement on eating, or we would all eat the same thing. LCHF can be from 20g of carb a day to 120g’s. it’s a broad church :slight_smile:
Do you agree that the best way for a T1 to control their weight is by the amount of carbs they eat and therefore the bolus they need? Given that insulin is a fat storing hormone.

So sorry, this is a lot to deal with. Maybe ask your doc about other t1 teens and support groups?Losing your pancreatic function is a such a huge betrayal and grief event but if she could see others venting and coping with it.

“That’s ok, I don’t take offence. there can never be total agreement on eating, or we would all eat the same thing. LCHF can be from 20g of carb a day to 120g’s. it’s a broad church :slightly_smiling:
Do you agree that the best way for a T1 to control their weight is by the amount of carbs they eat and therefore the bolus they need? Given that insulin is a fat storing hormone.”

Yes, it’s a broad church (or a broad temple for us Yids!). I believe that one of the top ways for anyone to control their weight is by cutting down on carbs.

Afrezza does work and does take down high blood sugar within an hour. Also, taking out a small whistle type device for inhaling insulin, which can be done directly after eating due to the speed at which it works would make Afrezza oh so easy and oh so discreet for a teen newly diagnosed. Afrezza is wonderful for the newly diagnosed as they do not need to deal with injections very often (they still will have to wear an insulin pump and change sets every three days) or a basal insulin such as Tresiba, which can be given only once a day and is flexible as to when you inject. For instance, with Treseba, you can technically dose within a 6 hour time frame if you are late or a bit early. But you cannot get Afrezza for a 16 year old yet. You must be 18 or over to get Afrezza. They are working on this and this will change. But the severe psychological crisis your child is dealing with, being diagnosed with a chronic disease that demands her attention every three hours a day… She will need a psychologist to help her, preferably one who has a practice helping children with chronic disease. A self-help group (call JDRF) or your local hospital will also help. To make the task of monitoring your blood sugar easier, the Dexcom would be ideal. She could just look at her iphone. And a pump with a remote also would help her remain compliant. Such as the Omni pod. Small, discreet, able to hide it under clothing easily. Dexcom same. If she would only use one, I think I would choose Dexcom. If not on a pump, only Tresiba gives both 24 hour coverage and flexibility in time of dosing (i.e., if she is at the movies with friends and does not want to dose at 9pm, she can dose within 6 hours either way. If she normally doses at 7am before school, she can sleep until noon on the weekends and still dose). I am recommending Dexcom first only because she probably is resistant to checking her blood sugar in public. She can always go off to a separate area and inject insulin if she does not want to inject in public. Good luck. This is very hard and I think the teen years would be one of the hardest ages to face a new diagnosis.

Type 1s are usually not overweight, although of course they can be. And never on mixed insulins, but need both basal and bolus insulin. Unless you are referring to the Regular insulin mixed with NPH a lot of them are put on right after diagnosis. These types of insulins are very difficult to deal with. But perhaps if she has a fixed lunch time and always eats without fail, you could use one of these insulins so she doesn’t have a lunch shot at school. That might work for now. Also, children and teens need carbs to grow so they are not prohibited carbs although they will be eating far less carbs than your normal teen. A CDE nutritionist should be part of their diabetic care team. Children and teens are given “normal” levels of carbs and bolus for it. If a teen wants to change her diet, he/she does so by choice. You may find a lot of teens going vegetarian/low fat (like my DD). But eliminating a whole class of food, such as carbs, is not easy. I don’t think it’s healthy (though a lot of people disagree and it should always be the PWD’s choice). You need to get a book on the glycemic index and learn how to cover the food you do choose to eat with insulin. And, since even this rarely works all the time, you need to check blood sugar two hours after eating and correct either way. But none of this advice will help because most teens will have such a hard time dealing with diagnosis and will need psychological help to deal with the grief and loss that comes with the diagnosis.

Have you asked your daughter why she’s not taking care of herself? If she was my daughter, I would want to know her answer. She may not have an answer at all, but i would encourage her to voice her feelings. I would also encourage you to keep the communication lines open, not the easiest thing to do with teens, I know.

As the mom of a teenaged girl with T1 & having survived the adolescent years with several teens already, I think one of the worst things we do as parents of T1s is put too much on them too soon. I know the popular thing now is to start pumping & CGM as soon as possible after dx, but I didn’t do it with my daughter & I don’t agree it’s the right thing for every newly dx’d child, regardless of age. I also don’t believe it’s a good idea to put them in charge of their D management, & experts such as Dr. Barbara Anderson & Joe Solowiejczyk agree on the damage it can do. In our race to control the numbers, I think we sometimes overlook the emotional impact on the young ones who don’t yet have the skills to cope.

Personally, I think counseling should be mandatory for all newly - dx’d children & their parents/families. It’s a monumental dx that very few are prepared to deal with.

[quote=“rgcainmd, post:10, topic:50636”]
Amanda’s daughter is angry and resenting the control and “normalcy” that T1D has recently stolen from her, the last thing she needs is a radical change to a diet that is likely very different from her peers.
[/quote] true she don’t need a change to her diet. &

she is not overweight. & as for why she won’t take care of herself. is due to one thing she don’t want diabetes. she have told me she wants to die then deal with it. & as for trying to cuddle and a cry over how much t1 sucks. she won’t talk to me or anything. other then Leave Me Alone mom or ugg or just let me die. it all she says to me. & this is someone who won’t Leave mom Alone or me Alone.

Yes Afrezza is for 18 years and older but know teens( boys) 16/17 using it off label and doing so great…I can pass on the contact info so they can connect and may be relate…and see if Afrezza is an option

Who doesnt freedom from carb counting, pre bolusing, pumping and defensive snacking and more than all better quality of life and making diabetes an after thought?

Hi, LCHF can actually put on weight if you want to, A lot find that watching their carbs can make the highs and lows less dramatic, smaller doses, smaller mistakes

newly DX girls and boys are very often skinny and malnourished before the DX is made. sometimes they are put on a twice a day Humulin 70/30 or similar initially before moving on to MDI or pump. The boys and girls start to bulk up again. people say how well they look, some just see fat in the mirror, their body image lags behind and doesn’t see it as good. If not rectified this can lead to diabulimia and real problems in the 30’s. We’d all be aware of the CKD and transplants.

It is a shock to a teen, she sounds very angry and upset and needs to talk with someone about it. I’m sure there is help for her to come to terms with it in your state. Have you spoken to her treating Dr?