DEAR ABBY: Last year, during her required physical for college, my 19-year-old daughter, “Lacey,” was diagnosed with Type 2 diabetes. She is in denial and hasn’t seen a doctor since. She doesn’t take her medications and refuses to change her diet or exercise. She is also obese.

When I try to discuss this with her, she gets angry and storms away. Her school is three hours away and I’m worried something terrible will have to happen to make her get serious. She’s in that “invincible/know-it-all/I don’t care” teenage phase of her life.

There are already signs that her diabetes is out of control — headaches, vision changes, foot sores, numbness in her hands and irritability. Any advice before it’s too late? — WORRIED SICK IN VIRGINIA

DEAR WORRIED SICK: Yes. There may be many reasons Lacey doesn’t want to deal with her diagnosis right now. With starting college, meeting new friends and navigating the transition to adulthood, she has a lot she’d rather focus on, and issues that seem more immediately relevant. It may also be scary to think about her health, the possible consequences of diabetes and all that managing her condition entails.

People Lacey’s age don’t like to be told what to do or be nagged. So approach the issue as a CONVERSATION and demonstrate an interest in HER perspective and goals. This can happen in bits and pieces over an extended period of time, as she comes to see you as a supportive resource.

You might start by saying, “What did you think of what ‘Dr. Jones’ said about Type 2 diabetes?” Then LISTEN. Resist the urge to tell her to do something. Instead, reflect back on what she says — even if it’s something you’d rather not hear, such as, “I have too many other things to worry about right now.” Your goal is to get her talking and thinking, and let her know you’re willing to listen and let her make her own decisions.

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Once you get her talking, listen carefully for any signs that she’s considering changes (eating more healthfully, joining a gym, trying medication suggested by her doctor) and show an interest in her thoughts, such as, “So you’re thinking about eating healthier? What have you been doing?” Offer concrete support such as offering to help cover the cost of the gym, looking up diabetes-friendly recipes or helping her connect with a doctor close to her school. Tell her you’ll support her any way you can.

In the meantime, engage in behaviors that Lacey needs to adopt, i.e., learning about diabetes and maintaining healthy eating and regular exercise habits. When she’s home, set a good example. Tell her what you’re doing and ask if she’d like to join you. Some resources you might find helpful are www.diabetes.org and www.mayoclinic.org/disease-conditions/type-2-diabetes/basics/ definitions/con-20031902.

Change isn’t easy. Progress often isn’t a direct path. Remember, diabetes is just one part of her life. Let Lacey know she’s valued as a person and capable of taking care of herself. But ultimately, the decision to do that must be hers.

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Dear Abby is written by Abigail Van Buren, also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Contact Dear Abby at www.DearAbby.com or P.O. Box 69440, Los Angeles, CA 90069.