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TJR

Discussion in 'Introductions' started by TJR, Jan 25, 2016.

  1. TJR

    TJR New Member

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    Jan 25, 2016
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    Ok…
    I’ll try and be short. My 14 yr. old niece who has lived with my wife and I for the last 5 years since her diagnosis of Type 1. She was kind of asked to leave because my wife couldn’t deal with all the lies and cheating.
    She is now living with dad and his new wife. Dad leaves for work at 3Am and returns home at 8PM. The step mom is clueless with her tricks etc.
    I’m still the one who takes niece to all the doctors so I so I still have an active role.
    I asked her how are things with Dad and the BS. She told me all is good. I asked her how that is possible due to the fact that while with us her BS would range would from 70 to 375 and higher. Her last A1C was 11.1 in December.
    She confided with me in that her new trick is two meters. She takes her BS with her spare meter and if it’s high she does her injection of insulin and when it’s lower she takes her BS with the meter she shares with her doctor and dad. So ALL looks good.
    I have several questions.
    Should I turn her in?
    Should I wait till she sees her doctor and hope the A1C results indicate a much higher reading then the meter she is falsifying?
    Will this actually come up in the A1C results?
    Will there be a difference with her doctored meter vs the A1c results?
    I am taking her to the therapist but I have a feeling it’s ALL lies.
    I’m telling you this kid could blow away ANY lie detector test.
    Thoughts / comments / advice

    T J R
     
  2. Mimikins

    Mimikins Approved members

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    The A1C never lies. It estimates average BG over a 90 day period, so any highs she experiences -regardless of if they're documented in her meter- will affect her A1C. Often, diabetics are shocked that their A1C ends up being much higher than their meter average, especially if they're only testing during times when their BG is usually lower (fasting vs. 1-2 hours after eating).

    Most endos will quickly notice any discrepancies between meter averages and A1Cs, especially if the meter she uses has "perfect numbers" while her A1C far from those numbers. I don't know if the endo could use any information that you give them about her diabetes management (I don't know whether that would fall under a HIPAA violation).

    In terms of telling her father, it really depends. The big thing I am concerned about is that any noncompliance in diabetes care now would really increase her risks of developing complications later, but the most important thing is that she is (assumed) to be taking her basal insulin and is subsequently reducing her DKA risks. One of my sisters is around your niece's age, and it's difficult; you want to give them more freedom, but at the same time she is showing you that she isn't mature enough for the extra freedom. It's been five years since her diagnosis (and she is now handling her diabetes on her own), which has me wondering whether she is simply burned out. I would also be interested in why she is trying to deceive her father and endo with falsified BG results -is she afraid of being punished if her BG is out of control? Would the step mother be willing to attend diabetes education classes and possibly take hold of your niece's diabetes care until she is more comfortable with managing it herself?
     
  3. sszyszkiewicz

    sszyszkiewicz Approved members

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    First and foremost, you deserve a thank you for caring. You may not get that from the immediate circle of family, but it is deserved.

    what does this mean?
     
  4. MomofSweetOne

    MomofSweetOne Approved members

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    An A1C of 11.1 is what my daughter was at diagnosis. She had large ketones but not yet in DKA. Another couple days, and I think she would have been.

    I would definitely turn her in. This can literally be a matter of life and death. Just drop by the Test One Drop facebook page and browse to see what can happen, even to those with a dx.

    It sounds like there's lots going on in her life beyond T1D. Would inpatient, intense counseling be appropriate with someone else managing D while the other issues are addressed?
     
  5. rgcainmd

    rgcainmd Approved members

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    I have to agree with the above. This situation is way past respecting the confidences of an adolescent. This is a matter of physical health and safety, both in the present (risk of DKA) and future (risk of complications). Like MomofSweetOne, my then 11-year old's A1C was just a little higher at diagnosis than your niece's A1C was while she was living with you. If your niece's A1c was 11+ when she was with you, it is now likely even higher! The goal for the A1C is 7.4 and under. There is a likelihood that your niece is laying down some significant physical damage and has been doing so for quite some time. If you are unable to manage her (her father and stepmother clearly aren't) foster care with a family trained in dealing with Type 1 and behavioral issues may be the best option for your niece...
     
  6. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    I do not understand this post. "Turn her in"? What exactly does this mean? And how can you, if you've been her diabetes guardian for 5 years, not know that the A1c will expose the truth of her meter trick?
     
  7. DiabetesMama

    DiabetesMama Approved members

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    It sounds like this young lady is facing several problems in a lot of different areas of her life. Almost sounds like abandonment issues from her parents Being a teenager is hard enough, then throw on that a disease and an unstable family life and she is really struggling. You are to be commended for stepping up and doing what you could, but it sounds like she is on a very destructive path. I hope someone can intervene before it's too late. I agree with SarahMaddie'sMom, how could you not understand that the A1c will tell on her? Was she not getting the regular care, every three months to check her numbers? That little meter trick is simple, but the A1c will not lie when it comes to her current status. It is an average of the past three months, so if she was getting the correct care, it would have sent up alarms way before now. I hope that you can figure out something for your niece, maybe counseling or a foster family that has good knowledge of diabetic care. Sometimes we just cannot handle all situations the way we would like, but it sounds like you tried your hardest and that is what counts. I wish you the best and hope you can get something figured out for her well being. You and your niece are in my prayers. Please keep us posted about her.
     
  8. glko

    glko Approved members

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    Couple of thoughts:
    1. She is 14 with very little day to day support or supervision at home. I would commend her for even testing her BG with the "secret meter" and giving insulin.
    2. Talking to her about long term consequences of her BGs is not going to help, she can't imagine next week let alone 10 years from now
    3. If possible I would try to get her permission to discuss this with her endo while you are at her appt, in order to not betray her trust but also get the truth on the table. Try to find out why she is afraid for others to know her BGs are high? She is testing and she is giving insulin, 2 good things. Does she feel judged when her numbers are high? Is she afraid of getting in "trouble"? If you can discuss with her and the endo in a judge free environment perhaps she will see that the only one she is hurting is herself and others are on her team, not working against her.

    Teenagers are smart, they will find ways to keep secrets if they don't feel safe. Unfortunately for my sister in law with Type 1 the secrets came back to bite her big time and she died at age 26. But she never believed all the people who told her at age 14 that her choices had consequences.
     
  9. mamattorney

    mamattorney Approved members

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    I feel bad for this young woman. And for you since you seem to be part of her care, but not part of her care at the same time.

    I just think about my own daughter and all the changes I make to her basals and to her ratios in an attempt to keep her in a decent place. It takes a ton of space in my brain; I can only imagine trying to do it on my own at age 14. If she's just following a basic formula set by her medical team a couple of times a year, I'm not surprised she's high, low and everywhere in between. She could be doing everything right and still be really high hours after eating if her needs have increased. Of course it doesn't help to lie, but she may think that everything should be perfect if only she follows the protocol set by her team. Unfortunately, that can be far from the truth the day after she leaves her doctor appointment.

    These early teen years with the growth, the hormones and everything else are so tough with diabetes. You never know what will happen next.
     
  10. TJR

    TJR New Member

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    MY heart goes out to all of you. See, I’m the compassionate one. As I type this, the tears are running free but that’s just me. This kid is a beautiful, extremely gifted 14 year old. I have spoken to her from the heart about the long term possibilities. I have used every example possible…even myself with nerve damage to both feet. Right now her fear is Dad and what he will do with the high numbers. If he finds out she is scamming the system he will lose it for sure.
    I’m working on triple teaming both Dad and my wife. I want the therapist, myself and her endo to recommend she move back in with us. My wife is rock solid in looking at a meal and calculating the carb to insulin ratio. I just have to control the anger issues. I can’t just walk away like others have done. She lived with us for 5 years and I just can’t walk away. I have told both Dad and my wife that WE can’t CONTROL her. Our job is to love her and guide her in the right direction.
    I will get this resolved. I WILL keep you posted.
    Thank you all…..TJR
     
  11. sarahspins

    sarahspins Approved members

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    While this is extremely troubling, lets look at the positives - she IS testing! That's huge, honestly. She might be operating in a somewhat dishonest way about it, but at least she is testing.

    In your position, yes, I would bring this up with her doctor, because her meter is going to show she's testing less than she actually is (and this may impact her ability to get "enough" strips on her RX if the doctor has no records to provide to insurance if they ask, and in an age of rampant insurance fraud, more and more are asking for "proof" of the number of tests patients are doing), and as you suspect, her A1C won't match her meter average. Sometimes this happens for truly legitimate reasons (I test more often when I'm high, for example, so that often skews my meter average upwards, which I realize is the opposite of your problem, but my a1c is fairly close to my dexcom estimate) and doctors honestly ignore it, but in this case, I do think it's important that they be aware of what is going on.
     
  12. quiltinmom

    quiltinmom Approved members

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    Sounds like her dad is a big part of the problem and needs to be educated. Maybe she wouldn't feel the need to hide it if he could realize that high bgs happen in every type 1, despite every effort. I don't know if there is anything you can really do in this area, as he is an adult and probably has made his mind up already. If you can get her back, it's probably best for her, although if it causes you family stress you have to weigh that too.

    I feel so much compassion for the situation you are in! Even if she doesn't live with you, you can Continue to be supportive to her and just try to be the "cushion" she can fall on, if nobody else in her life will be. You are a saint for taking in any teen, much more so for taking in one with diabetes!
     

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