I have been through this on the other side and I think you need to consider what your foster daughter is actually feeling rather than dismissing her as 'irresponsible'. Yes your bio daughter may have been perfect. But people are all different. I for example did not check my blood sugar because I was so very terrified of complications that it paralysed me and I could not even think about my diabetes let alone deal with it. I felt totally alone. My family care about me, but it came across as nagging, and the doctors also nagged. I felt scared and alone and attacked. I had no idea what to do about my blood sugars, was never told how to adjust my insulin so if I had checked my blood sugar I would not have known what to do with the result.

So my advice is that you speak to your foster daughter gently and try to find out what is really upsetting or stressing her and why she feels unable to care for herself. Diabetes charities where I am organise holidays for diabetic kids and their parents, I don't know if they do where you live but it would be worth looking into. Find out if she actually knows how to adjust her insulin - it is shocking how negligent doctors can be in teaching diabetics self-care and management. Also consider that your daughter had a secure loving family and presumably also good medical care. Your foster daughter is being fostered so presumably something has happened with her parents to cause that, and that could have effects on her self care too for example if she feels abandoned by her family and worthless, so she sees no point in caring for herself. I am not saying this is the case but it could be, and I definitely think you need to think about other alternatives other than her being irresponsible.

Even if they do have happy families and good medical care, many diabetics find teen years incredibly stressful, Our blood sugars are erratic and uncontrollable through no fault of our own, because our bodies are changing. Our emotions are a rollercoaster. We are suddenly expected to take care of our own diabetes after years of doctors and parents doing it for us, which is impossibly hard. Our friends are all going out, getting drunk, etc, which is not possible for a diabetic and this feels restricting on us. We need gentle support and care to enable us to care for ourselves. Many of us go through a period where we rebel, and we need support to get through this in our own time.

I hope you and your daughter find a way through this. Please ask if you have any questions. I know it must be very hard for parents and loved ones. I apologise if I seem aggressive but I feel strongly when diabetics are dismissed as "irresponsible" as if we want to get complications. I wish you and your daughter the best of luck.

lizzie where are you from? I wish there were orgs here in south FL... I am actually starting one to help diabetics with complications and would love to get ideas on things yours did to help!

Lizzie,Thank you for sharing your insight on this.I can see where what we are reading in her may not be what it seems.Knowing her background all of what you say may apply.She is one of several siblings removed from their mom because of neglect.She had been in the hospital on an emergency basis more than once and is afraid to go back because of it.My wife has been working with her to figure boluses but though she tells her what times of the day to check it she usually has to be told every time.It's about to wear my wife out.

Hi again Vectoman

I really think you need to contact a charity or speak to your daughter's diabetes team, you seem like you need extra support from somewhere anyway. It seems to me like the family has got set in their attitudes and without outside support it will be really difficult to change. Your daughter sounds like she needs support and counselling to sort our her feelings and teach her to manage her diabetes. Maybe it would also be helpful for your wife and you to speak to someone, it must be hard to parent a diabetic and speaking to a neutral outsider might release some tension.

I looked up the American Diabetes Association and found this link to their summer camps: http://www.diabetes.org/living-with-diabetes/parents-and-kids/ada-camps/?utm_source=WWW&utm_medium=DropDownIMC&utm_content=Camps&utm_campaign=CAMP which seems like something which might be helpful to you.

Angla23, have you looked into the ADA? I am in England where we have Diabetes UK: www.diabetes.org.uk. They have good support services and also offer camps.

I agree with the sentiment that she may need to work with a therapist. 14 year old girls from normal situations sometimes have difficulty dealing with T1D because of a fear of being social stigmatized, low self-esteem, 14 year old irresponsibility, and any number of other things. I think, given her background and life context, that she may have some emotional issues blocking her from embracing her condition.

Just wondering; how long has this girl been with you?

I also take exception to calling someone "irresponsible." Even if it's technically true, it's an unfair label, especially to someone so young. Comparing her to your bio daughter is, to me, horrendous. She obviously has never had the support, love, and care that your bio daughter has had her entire life. No examples of how to take care of herself (or anyone else), and no encouragement. You think this is hard on you?? Try her side.

It is entirely normal for someone to rebel and not take care. I've been through it. I still go through lapses now and then. If your bio daughter never does I would be shocked.

I agree that this girl probably needs some type of therapy. She also needs understanding and TONS of patience. I personally wonder if maybe she's behaving this way because your wife does remind her. She needs to know that she (your wife) still cares. It may seem silly to you, but she needs that constant reinforcement, needs proof, even if you think she's been given it. Perhaps her mother had short spats of "caring," but always failed her again. She may be just waiting for the day that someone fails her again. Wouldn't you need proof after that?

You said that your wife is being worn out by this. Are you not able to help?

I totally agree with 1stmayflowers. They have said the things which I also wanted to say but couldn't find a tactful way of doing so. I also do not like the comparison with bio daughter or the use of the terms 'responsible' and 'irresponsible' for the two girls. It is far more complicated than that and if you really want to help this girl and give her the support she desperately needs you should try to see that and stop using those words and comparing the two girls.

Ouch ! You guys dont spare any words.To update.She has been with us almost three years and her health is good.Her sugar levels seem to be harder to keep down normaly than our other daughter.She tends to be a quiet person and had a therapist but didn't really seem to want to open up much to her.I had a talk with her and the thing that seemed to bother her most was other people telling her what she should be doing(other than my wife,our other diabetic daughter and I).There are others well intentioned who say things about taking care of herself who she feels don't understand.It could be also that she just doesn't want it brought up all the time outside of a close family group.Any specific suggestions on learning to figure insulin amounts and ways to remind oneself to check sugars at the needed times?In talking with her fear did not seem to be something that was paralizing her ability to do what she needs to.

Hallo again Vectoman

I have a ratio system to work out my insulin and carbs. Do you/she count carbs at all? If not you should, I think it is impossible to work out insulin unless you know what you have eaten.

My ratio system has a certain amount of insulin units per 10g of carbs. I had to figure this out on a course under the supervision of a nurse (in case of highs and lows etc). So I would say you need to do the same, work it out with the nurse. You start by taking 1 unit per 10g carbs, see what happens, if needed move it up or down. Don't make more than 1 change in 24 hours. You may need to alter the long acting insulin if on that too. Is she on a pump or injections?

In terms of reminders, you can set these on a mobile phone or put sticky notes where she might notice eg on the fridge etc. If her meter connects to a computer you can see patterns in results more easily.

If her sugars have been out of control for a while it will be more difficult than with someone who has always kept control. But you have to see your bio daughter has been incredibly lucky with her care and having a loving family who are interested in her diabetes care. If you don't have those things it is much more difficult to motivate yourself and get into a routine at an older age.

does she have a cell phone? if so this is one great way to remind her to check.(my wife actuelly does this with me because i have a tendency to forget to check my sugar sometimes). have her set alarms on the phone to help remind her to test. if she has a smart phone (like an iphone) it makes it even better. they have software for most smart phones that has alarms and a sugar/insulin charting.

on an emotional note...being a teen with diabetes is extremely hard. no matter how hard u try, u are not normal. she is at the age that not being normal(as normal as a 14yr old girl can be) can be extremely depressing. even if none of her friends see her as being different, she feels she is.

being a teen with diabetes means everyone expects u to act like and adult...but your still a teen. so everything is overwhelming. im 23 and i still sometimes feel overwhelmed by life with no small part of it being my diabetes.

She is on a pump, and her ratio is about 1 unit to 8 carbs.(Our birth daughter's is 1 to seven and a half)That seems to be working with her.No cell phone yet but the alarms sound like a good idea.

the alarms are a life saver. couldnt tell u how many times i would be sitting on the computer or on the couch and be thinking it is still like 6pm...and my 9pm alarm goes off and i would be like "who the heck is calling me" and then realize what time it is.