Diabetes and poor control

[nursekoll, BSN, RN]

Hello fellow school nurses! I have a T1D student who was diagnosed 2 years ago.  Lately I've been dealing with poor control of blood sugars. I suspect this student has been sneaking food/snacks and not dosing for them. We monitor blood sugar closely at school and correct as needed. With the dexcom I can see what blood sugars are over the weekend and all evening/night at home. This kid is maxed out at >400 for 8-12 hrs outside of school hours and then we try like hell to get back in the normal range during the school day. Parents are very nonchalant about it. "Just a kid, *shrug*" It's super frustrating to see them not correcting or controlling (caring) at all at home/evenings and weekends. How do you motivate families or kids to take better control of their health?! I feel that many kids and parents have the mentality that it's "safer" to run high than low and they don't consider the long-term effects. At what point would you contact the student's doctor or even CPS for suspicion of medical neglect. Kid is supposed to be getting a pump soon, so I'm hoping that will help. Thoughts?

[School.RN.forever]

I have a student with similar issues. I have contacted her diabetic educator since she signed the consent form. I stay in touch with the educator because she touches base with parents frequently when I feel like something is off, and keeps them educated (on top of my own education)