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Re:[IP] Teens and Pumping

Hi Carol,
Date: Fri, 4 Jan 2002 19:37:16 -0800
From: email @ redacted (email @ redacted)
Subject: [IP] Teens and Pumping

My fourteen year old daughter has been on the pump now for about five months
and loves it.  She was diagnosed at the age of 2 1/2 years so for the first
time in 12 years, she is able to sleep in, eats at different times of the
and eats a lot of what she wants.  That's the great part about the pump.

*She's experimenting with being "a [more] normal teen".

However, she seems to be having a hard time controlling some of this new
founded freedom as she tends to "graze" most days and eats lots of high
foods when it's available to her away from home.

*Like when out with her friends-being just like her peer group?   Does she
only get high sugar foods away from home when no knowledgeable adult is
around to help figure how to cover these?   Ah, that forbidden fruit

 Sometimes her readings are in the high 200's and 300's and this doesn't
stop her from eating more.  She boluses large amounts of insulin to cover
some of her high readings and I'm afraid this practice is just a major
insulin reaction waiting to happen.

*Feeling hungry goes along with out of control blood sugar levels, and maybe
her large boluses are just causing some hypoglycemia to start, body reacts,
and up goes blood sugar.  She may be expecting instant decrease in glucose
levels without comprehending the mechanism behind how insulin works, the
time it takes.  Also, if you should happen to comment on her eating more
when she's in the high 200's and 300's, she's probably not really hearing
you, but hearing "The Mother" telling her what to do.  Yes, there is
potential danger to this.  I'm sure you've got a copy of "Pumping Insulin"
just lying around in a spot where she could glance at it without you

She won't keep up her log book without being harrassed and recently started
making up numbers to hide some of her high readings and also omitted some of
her boluses to hide the amount of carbs she's eating.

*So harrassment may not be working, huh?  And how did you find all this out?

She's a great kid and I love the fact she no longer has to give herself 3-5
shots a day but I am very worried about what she's doing to herself.  Facts
and information are just a waste of time with her.

*She isn't into knowledge at this point, just into trying to be a teen and
handle the hassles that go with it.

Help!  Does anyone have any suggestions because I am very frustrated ......

Carol, Mom of 14 year old pumper
Ok Carol, here are some more thoughts:
    Do you have a good endo, CDE, and nutritionist?  If so, I think I'd let
them have more active involvement so that your daughter doesn't see you as
the "interferring Mom".  If you don't could you link with any?
At her age, she's really trying to gain some independence (good/bad ways),
is going to get the hungries often, and running high can just make things
worse.   You probably don't condemn or criticize her behavior, but remember
any comment out of your mouth can be misinterpreted by her.  Just sit her
down and let her know that you are thrilled that she's growing up to be such
a lovely young woman, and want to find a way to work with her so she can
enjoy the foods she likes while finding a way to keep her glucose levels a
bit better.
Let her know that accurate records will help to make this process easier,
that yes, sometimes highs happen without rhyme or reason, but dealing with
any high in the healthiest manner is what counts.  Maybe there can be a
compromise on when/how often she needs to test her glucose level, and maybe
she needs to plan to bolus before those teen treats pass her mouth.   Maybe
she and someone you trust could together make sure on a daily basis that her
records are accurate.   And, as much discussion here has said, those
Also, target range may need to be reconsidered for 2 reasons: 1) so she may
be more attuned to doing what she should, 2) to compensate for theose
hormones.  If she is given a bit more leeway for a while, she may do better
with control, and then another adjustment in target range could be done.
She probably reaches a point of "Oh, forget it.  I'm so high now it doesn't
matter, I'll only get read the 'riot act', and I really didn't do that much
bad [teens discover total rationalization or maybe she didn't do that badly
all things considered].  I feel ok so what's the problem [20 years down the
road doesn't count; and the more a teen hears about complications, the more
a teen wants to do just what they want when they want]."
Do her friends have any awareness of diabetes?  I ask only because I know of
a teen guy whose friends would make fun of him (yeah, some friends) if he
declined treats, and hadn't an inkling of why he had a pump so they'd make
negative comments about him bolusing to cover treats.   He wanted so badly
to prove he was just one of the guys that he wouldn't check his glucose
level if out with these "friends", didn't bolus to cover the high carb
extras, and almost ended up in DKA in the hospital.  He joined a teen pump
support group (CDE referred, no parental mandate), found out there are lots
of other teens in the same boat, they gave him tips on how to deal with
those "friends" and he eventually took more responsibility to: monitor
glucose levels, take boluses, and (to parents amazement) tell some of those
"friends" take a hike.  He began to see that they didn't really care about
Your daughter sounds like she's trying to take control of her life in any
way possible, even if it's by doing what she knows will "press your
buttons."  The best way to get a teen's attention is to give praise for
little positives even if it means biting the tongue over a negative big
enough to sink the Titanic.
Just think though, she'll grow up in a few years, and if there's justice,
she'll have a teen to deal with someday.
Marj; Mike; and "Ace, the PP" (portable pancreas)
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