مراهقة عمرها ١٦ سنة عندها سكري النوع الأول، سكرها التراكمي ارتفع من ٧٫٥ إلى ١١٪، ونقص وزنها، وأمها وجدت أقلام إنسولين لم تُستخدم. تقول إنها تخاف من زيادة الوزن. العلامات الحيوية طبيعية. ما الإجراء الأنسب؟

A 16-year-old with type 1 diabetes has HbA1c rising from 7.5% to 11%, has lost weight, and her mother found unused insulin pens. She says she is afraid of gaining weight. Vitals are normal. What is the most appropriate action?

1. Increase her insulin dose without discussing the reason at all
2. Non-judgemental talk about omitting insulin and specialist referral
3. Allow her to reduce insulin because she is a teenager
4. Threaten hospital admission if she does not comply

Answer: B) Non-judgemental talk about omitting insulin and specialist referral. Insulin omission for weight control is dangerous in adolescents with diabetes, raising DKA and complication risk. It needs supportive conversation and referral to a specialist psychological and dietetic team.