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Apr 08, 2013
Read a case study from the Diabetes Center about an 16-year-old female and her family negotiating living with diabetes through the teen years.
Amy Lee is a 16-year-old junior at a local high school where she is an average student, plays on the traveling soccer team, and plans to attend college or join the military after graduation. Over the past year, there has been a noticeable increase in tension between Amy and her parents. Amy feels that her parents are intrusive and unreasonable. Recently she has requested permission to obtain a learner’s permit and is dating a boy with whom she spends a significant amount of time. Amy’s parents do not approve of the boy and have good reason to believe that there is alcohol involved in some of Amy’s weekend activities.
This scenario includes many of the challenges that providers who care for adolescents encounter on a daily basis. Now add the overlay of type 1 diabetes: Amy has had diabetes since she was 3 years old and has worn an insulin pump since she was 7. Although her diabetes control has slipped (last Hba1c 8.2%), previously she was in excellent control (no hospitalizations for DKA, hypoglycemia; Hba1c 6.8-7.3%). Until Amy was 14, Mrs. Lee was the primary manager of Amy’s diabetes, and until recently Amy followed the rules and was very cooperative. She is now sullen, noncommunicative, and angry much of the time.
The Diabetes Center for Children at The Children’s Hospital of Philadelphia is developing a program specifically to support adolescents with diabetes and their families as they negotiate living with diabetes through the teen years. Building blocks for this program include:
To refer a patient to the Diabetes Center for Children, call 215-590-3174.
Contributed by: Kathryn M. Murphy, RN, PhD
Endocrinology, Children's Doctor Spring 2013