Diabetes management in a teenager - how to get him to be sensible? Experiences please

[mears]

DS3 was diagnosed in February of this year and DH and I have marvelled at how well he has adjusted to injections and modifying diet.

However, he has lately not been testing his sugars on a regular basis. This started when the diabetic liaison nurse said he could have the odd day off. Last week he did not test for 5 days in a row with the reason being that he 'knows' when he is high or low. He always tests when he feels hypo BTW.

I totally lost the rag with him the other night and had a go at him, telling him that he was not displaying any signs of maturity. He admits he 'can't be bothered' testing.

He tested yestaerday and is running high in the morning 10.9, but my argument is that he needs to do regular tests to identify a pattern. He point blank refuses.

Will he come round on his own to my way of thinking? Anyone been through this? I know there are experienced insulin users out there. Any comments welcome.

Bumping this for you mears.

I have no advice - I'm struggling with similar at the moment. I've handed over to dd the responsibilty for taking her meds; she's 'forgetting' to take them on a regular basis but I get the impression that it's a bit of rebellion. Thankfully they are quite long-lasting so I don't face the immediate issues that you do.

The whole thing weighs heavy on me at the moment as we begin the process of transition to adult care.

www.diabetes.org.uk/Guide-to-diabetes/Living_with_diabetes/Teenzone/

This along with www.diabetes.org.uk generally may be helpful to you both.

It goes without saying that he does need to test his sugars on a regular basis; I will never forget seeing a man on tv who refused to test properly when he was a teen. He became an adult with all sorts of health problems that could have been largely prevented had he tested his levels regularly.

That's the problem Atilla - I know the consequences. DS says he knows too but it is his body and his illness!

Soooo frustrating. I even said to him you could go blind and he said 'SO'. AArrgghhhhh

bumping for evening crowd

In addition to telling him he could go blind, suffer kidney failure and end up on dialysis, have bits amputated etc, how about reminding him that impotency is also one of the potential problems - may just get his attention a bit more!

Now there is an interesting point

Or lack of

.

Mears, is he Type 1 or Type 2?

I've got type 1 and my control was a bit hit and miss when I was about 17/18. I think the big crunch came when my consultant sent me a letter (I was leaving home to go to university anyway so it was a bit of a "hurry up and get yourself seen elsewhere" kind of letter)

Any consolation my control is now good and no complications. I think I would have been even worse if somebody was on my back all the time about testing etc.

Also Diabetes UK have regular holidays and weekends away for teens or families which I went on and found really helpful. Please ask if I can be any other help - it must be hard being a parent in this situation

He has type 1.

Since i posted this he has obviously had a think about things and has done more regular testing. His levels have been 10 + in the morning and 14 at lunch so he has increased his breakfast Novorapid to 6 units. He has an appointment at the clinic in November so i am going to go with him. His diary record has huge gaps so hopefully the nurse will say something about it.

Do you have a practice nurse at your surgery that you can phone? They might - at your request - call him and give him a flea in his ear!!

He really needs his sugars under 10 and if he is altering his dose he then really needs to check regularly to make sure the altered dose is working (sorry if teaching you to suck eggs).

I think the impotence card is a good one to play also!

My dh has type 2 and hardly ever checks. He says (like your son), that he 'knows'. Not good enough, but it gives some perspective. Dh is 49 and irresponsible with it, so a teenager would arguably be worse.

Dh's daughter, now 17, is type 1. She was diagnosed at five, and 'treatments' have improved year on year by a drastic degree since then.

She eats sweet stuff all the time, but the med's they've given her keep it under control.

The only way to get a teenager to take their med's on a regular basis is to appeal to their vanity

I wouldn't bother with practice nurse TBH. I could contact diabetic liaison nurses if need be but I think that he has listened to my rant.

When I spoke to the DLN before, she said it isn't uncommon for teenagers to stop testing so not to worry, but you can't help it.

oh mears, it sounds like he has taken the leeway suggested by the nurse and then driven a truck through it! I must say however that I would imagine this is pretty normal for a newly diagnosed T1 teenager and part of the whole grieving/denial thing.

Hey I was 30 something at diagnosis and I've gone through periods of being pretty lax on the testing (admittedly not more than a day or so though..). I also realised that I couldn't do it all perfectly and live life the way I wanted so eventually reached a middle ground that gave me control that was "good enough" for me (and enough to hopefully avoid complications) but allowed me to live life to the full as well. He needs to find where his middle ground is....and that must be bloody difficult as a teenager who now has a really good reason to be angry. He prob.does need to know that you understand he can't have perfect reads or do every test he should. He does care about the complications but they prob don't seem real to him...

No easy solution I fear, but hopefully he isn't missing too many injections and if he is still honeymooning everything will be a bit more forgiving anyway.

Ideas that occur to me:

Could you book him in to see the nurses by himself so he is in charge but prime them beforehand..do you normally go too? Maybe making him responsible would make him responsible if you know what I mean?

Find out about opportunities for him to meet similiar aged fellow T1s. From adventure type stuff, camps or just meeting up- maybe seeing others dealing with it will help.

The CWD website (I always go to www.diabetes123.com to get to it but it is the same site...) may well have parents of teenagers or teenagers who may be able to advise from experience...

www.realitycheck.org.au is the young persons site - maybe you could post on there to ask for their experiences if he isn't interested in using the site right now.

Sorry if this comes across as a bit preachy I obviously do not know what it is like to be a teenager with T1 or that T
teenagers mum. Hope some of my musings are of some use! Hope things get easier for all of you soon

oh I do type slow (or else type too much....everyone else already had my good ideas - but quicker!

Thanks Dilbertina.

I have let him go in himself to the last 2 consultations to give him 'autonomy' but i think he is taking the piss!

I will go with him next time. Carb workshops were mentioned when he was first diagnosed so I want to find out about those for him.

On the whole he is doing OK. His last 2 HbA1c readings have been spot on so he really has been managing fine. I just worry that he won't be on top of notcicng if his 'honeymoon' is starting to end.

He isn't a very sociable characetr at best and isn't keen on meeting new people yet - especially those with diabetes. That will come though I am sure.

I have tried to get him to look at websites but he isn't interested.

I have to keep reminding myself that it as only been 6 1/2 months since diagnosis.

Hi mears,

Sorry you are having a tough time with ds.

I fear I have all this to come - ds is only 10 and has had T1 since he was 5. He recently had his first eye scan as it was 5 years since diagnosis, which brought home to me the potential complications in store. But as he doesn't remember life pre-diabetes I'm hoping that testing and bolusing (he's on a pump) will continue to be such a normal part of his life that he will carry on doing it all (who am I kidding ). It must be really hard for your ds to be diagnosed as a teenager when they have so much else going on.

There are parents of teenagers on the Children with Diabetes support group I mentioned to you on ds's diagnosis thread, and I recall a recent discussion about at enager who had gone a bit off the rails - I didn't take too much notice as it wasn't relevant to me. There's also a Dad who has been T1 since childhood and now has a daughter with T1 who is full of good advice because he has been there and got the tee shirt himself. He might be able to suggest how you could approach ds. Talking about complications doesn't, ime, tend to have much impact.

We talked before about how often ds ought to be testing and I remember he was advised not to test that often. Has he maybe taken that relaxed advice to an exreme? If ds "knows" when he's high or low you might mention that the body gets used to being high or low, so you don't get th same symptoms. If my ds has had a couple of days on the high side, then he starts to feel hypo when he's in the sixes and sevens - if he were to treat all those without testing he'd be in the teens all the time. Likewise, if you have too many hypos you lose hypo awareness because your body gets used to being low and you need to run higher than usual for a day or two to recover it. Ds should also be testing 2 hours after meals to check that his carb ratios are still OK.

If the scientific approach won't work, is he too old to bribe for a week or two?

Hi Mears
I've had type 1 since i was 9 so what your DS is goin through now, i've been there.

I had a few very unstable years where i did too little in the way of testing and didn't have good control at all but i came through it ok and don't have any complications.

I agree with Tangarine, talking about complications really doesn't help. He knows they exist and that's something he has to live with every day. I know that when my parents used to go on at me i used to give them a hard time and i feel bad now cos it was only cos they cared. But at the end of the day they didn't have diabetes so they really didn't know what it was like, never having a day off from it, having days where sometimes despite doin everything right your blood sugars still go wrong.

My control is good now but i still do things that the diabetes police would disapprove of like getting drunk!

Going high is more of a problem but tbh it'll make him feel so rough he won't leave it long before acting, it's really not a nice feeling.

Is he on basal bolus, novorapid and levemir?

Hi Mears
just wondering how you and your son are getting on? is he making any little steps forward? Realise it won't have got easy but hope it may be getting easier.

Hi Mears, how are things ?
I rebelled in my teenage years. Didn't want to know or do any testing.
How is your ds doing at the moment ?

Found this thread when searching.3 years on and he still won't test. Sooo frustrating. Although DS still does not test regularly his consultant says he is doing something right as his HbA1C is good. I have sent him a link to watch from the diabetes episode of the hospital. It is so frustrating when you are a health professional and cannot persuade your own family to comply with medical advice.

A good friend of mine had a sister with Type 1. She was very lax about testing, her folks often got phone calls from her when she was going low and had to frantically drive around looking for her. She was found dead in bed aged 21, ironically with her testing kit on the bedside table. My step dad was diagnosed Type 1 at 30 years old, he is very very careful, but still goes low quite regularly. The doc has told him that his general health is excellent though, probably because of the care he has taken over the years in managing his diabetes. Its not a diagnosis to fuck about with IMO.

You are absolutely right glastocat but I cannot make a 19 year old test. Consultanat says it is good that he takes his insulin regularly and that he is somehow managing it fairly well. DS says he 'knows' whan his sugars are high and definitely knows when they are low.

I sympathise mears, it must be very difficult for you.