A tough one today, folks. What can an "outsider" do to help someone they see neglecting their diabetes and suffering the consequences? This is the call for help in the latest Diabetes Lifeline (interactive community help category) from a woman named Nancy in the Midwest. Again, I reallyLifesaver struggled with what to suggest here. I'm sure many of you have ideas...

Dear Amy,

Can you please refer me to any link on the web re: the short and long term impacts upon a 19 year old woman/girl, who has decided to save money by stopping her insulin injections. She is dating the son of one of my good friends. She has no health insurance and is working at a minimum wage job. She lives with her parents, to whom she gives part of her meager earnings - her father has colon cancer and is not working. I won't get into her whole dysfunctional family situation - but I would think that not getting any medical oversight or treatment for her Type 1 diabetes is playing Russian roulette in the short term - and I also wonder whether even if she at some point does start complying with the necessary medical treatment program, whether she will not have done irreparable, life-shortening damage to herself during these months that she has ignored her condition?

How is this young woman's behavior (neglecting her diabetes) hurting her loved ones and those around her?

Her mother seems to be completely focused on her father (battling cancer) - which is understandable. Mother works full time, and father's treatments are at a medical complex some 40 miles away from the family home. Older brother has joined the Marines - Heather says to get away from the family crisis. Father cannot work. The parents decided to continue (COBRA) only the father's insurance. This girl works 30+ hours a week in a grocery store, but has NO medical coverage. You might say that her loved ones are neglecting her, and that is impacting her diabetes.

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What is her boyfriend's reaction? How is he involved in the illness (or not)?

She tells her boyfriend she has a "very mild" case of diabetes. I question how "mild" it could be if she was prescribed regular insulin injections. Meanwhile she is pressuring her boyfriend to drop out of college, marry her and immediately have babies -- before her Dad dies! I have researched the complications of pregnancy/birth-defects for Type 1s, including the need to strictly monitor and stabilize oneself for months before becoming pregnant, etc. I would like to get some definitive statement regarding short and long term effects on any diabetic who stops taking insulin.

As a sort of "third party" in this situation, how do you think you might be able to get involved and help her?

At first, my thought was to talk with her about the necessity for her to get some kind of education so she could support herself, and at the time that she might marry and have kids, to contribute to her family's expenses. She had talked about wanting to become a hairdresser. I pointed out that she could take out a student loan, and share an apt. with other students. She was not interested in this.

As things progressed and I saw and heard the range of bizarre behavior, I realized that only her parents could really influence her to grow up. Unfortunately, they seem only to want her to get married and move out of their house. The parents' lack of care for her seems to exacerbate her obsession to find a man to take care of her.

Meanwhile, I think she has completely blocked out her diabetes from her consciousness. Very sad situation. It's been a nightmare of a rollercoaster for my significant other and I. I really do care about his son...

Not an easy one, for sure. So, People, what would YOU do?

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