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Januvia (Sitagliptin)

For some mixed-up teenagers, their diabetes provides the ideal weapon to get back at their parents, doctors and teachers. But, unfortunately, the only people they really harm are themselves. Every diabetic clinic has a small group of teenagers who are for ever in and out of the hospital in hypoglycemic coma or ketoacidosis. They give themselves insulin overdoses or stop their insulin for days at a time. They are usually very good at judging exactly how much extra insulin to give or how little. But every so often, one of them gets it wrong. Instead of waking up to find Mum and Dad looking anxiously down at them, they die. Those who survive may have done themselves permanent harm. Many of the ketoacidosis experts have had so many intravenous drips that they no longer have any clear veins left into which life-saving drugs can be injected.
Very few self-destructive diabetics are quite as calculating as I have suggested. Some of them may be desperately trying to get across the message that they are very unhappy.
Martin was fourteen years old when I first met him. He had had diabetes for three years and for half of that time he had been in and out of hospital with extremely severe hypoglycemia. On several occasions he had been unconscious for days at a time.
He went on a diabetic camp holiday and for the first three nights was severely hypoglycemic every night. Then a member of the staff saw him injecting himself with ten times the amount of insulin he should have had. Martin knew he had been seen and for the next few nights his diabetic control yo-yo’d from very low to very high, ending up with an episode of diabetic ketoacidosis.
When he returned home he confessed that he had been overdosing with insulin for eighteen months. He had been doing it because he felt it was the only way he could express how much he hated having diabetes and having to inject himself every day. He is happier now that he can talk about his feelings and has stopped overdosing, although his glucose control is still not very good.
What many teenagers with diabetes do not realize is that doctors and others involved in looking after diabetes understand that being diabetic can seem an impossible burden at times. You can say anything you like to your doctor, he is not just there to tell you to eat the right things and measure your blood glucose and give you the right amount of insulin. We know that everyone with diabetes has times when their control is very far from perfect. Plenty of diabetics have forgotten to give themselves an insulin injection at the right time at some stage. No one can be perfect all the time. All we ask is that you try your best. If things are going wrong, tell us – perhaps we can help. If you are feeling fed up and frustrated, tell us. When you are seeing the doctor, however busy he seems, you have the right to talk about your problems. If you feel that you need more time to talk, ask for another appointment and explain why.
Many clinics have diabetic specialist nurses or other helpers. Some people find them less intimidating and easier to talk to than the doctor. If you really feel that you cannot talk about all your worries and fears to the doctor who looks after your diabetes, ask your family doctor if you can see someone else. Similarly, if your family doctor is really not on your wavelength, ask him if you can see another doctor.

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