- advertisement -

17 year old noncompliance

Discussion in 'Parents of Teens' started by Robnleigh, Dec 22, 2012.

  1. Robnleigh

    Robnleigh New Member

    Joined:
    Dec 22, 2012
    Messages:
    1
    Yep - I have one of those kids. Just downloaded the pump and we have 13 days this month of no boluses. 7 days of no sugar checks at all. Yesterday was 525 with no correction (actually no bolus the whole day and only that one check). I ask everyday and get the "yep, I checked and am 225". Did you bolus? Yes - 8 units!

    A1C is over 10 now. Endo told him he would take him off the pump in January if he doesn't check 4 times a day. He has actually gotten much worse since he was told that. I have no idea what to do. I have emailed his diabetes camp counselors who he so looks up to to see if they can reach out to him. I am really just worried about his health. If he is running around at 525 we are going to be heading to the ER sometime soon. He keeps saying that he just doesn't feel that bad so he must be ok.

    He might not feel bad but I am about to lose my mind. Any one out here that can talk me off the ledge? Boy, it makes you feel like such a failure as a parent. Where is this in the "parent book?" :)
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    I'm sorry you are having such a rough patch. How long has your son been D?

    I would not allow a Dr to take away my child's pump. A pump is just an insulin delivery system, not a reward.:rolleyes:

    Without knowing more of your situation I can't offer much, but I would urge you to watch this video http://www.childrenwithdiabetes.com/video/JoeS2.htm Joe speaks about raising a D kid and how to help them "own" their D.
     
  3. danismom79

    danismom79 Approved members

    Joined:
    Apr 21, 2008
    Messages:
    5,300
    First, welcome.

    I don't mean to be nosy, but does the child live with you full time?
     
  4. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Hi there,
    First, I am a teen (age 19) so take what I say with a grain of salt.
    Several things though:
    1. You are not a failure. You are here trying to help your son.

    2. Can you talk to the endo about a dose of lantus each morning to ensure he is at least getting adequate basal? I would think that would be the endo's concerns with regards to the pump since theoretically DKA would happen quicker without lantus on board.

    3. Taking away the pump seems crazy to me (but I am not an endo). I can flat out tell you I would miss way more bolus's without a pump then with it. Pushing a few buttons vs. drawing up insulin in a syringe or priming a pen.

    4. The word non-compliance drives me crazy.

    5. I know your scared. Your son needs to do what it takes to stay alive, I agree. But it is really really tough to be a teenager and to be so different then anyone around you. I am happy to give him my email address or phone number if he wants to talk. I could also put him in touch with some boys with type 1 who went through the same thing.

    Good Luck! I had more then one double digit A1C as a teenager. I certainly don't have a perfect A1C now but I am doing much better, I am healthy, and I go to a great college. It gets better, it really does....
     
  5. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    So, now you know: you should check bg and enter it in for a correction yourself, probably every morning and every evening.
     
  6. sarahspins

    sarahspins Approved members

    Joined:
    May 5, 2009
    Messages:
    2,205
    I agree with this... if he can't manage himself, then he needs more supervision until he proves that he can. That could mean making him check his BG or it could be making sure he boluses, but you can't sit back and take his word for it any more.
     
  7. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,652
    I would not be threatening to take the pump, but I would be implementing practical measures including injections as needed to get the situation under control. This means having him measure and bolus under your direct supervision every day at breakfast and supper. I would also ask if he would prefer to go on an NPH injection to cover lunches at school , since he can't seem to be bothered to measure and bolus himself. Alternatively you could ramp up his basals so that he is being pulled down throughout the waking hours, to compensate to some extent for the missing boluses. I would try to be matter of fact about brainstorming with him about how to get a minimum of D management happening.
     
  8. Amy C.

    Amy C. Approved members

    Joined:
    Oct 22, 2005
    Messages:
    5,560
    I suggest you at least look at the meter and pump every day. Do not allow two weeks to go by without knowing what he is doing -- and asking him to report it will not work.

    Other suggestions were good and you ought to consider these as well.
     
  9. djfye

    djfye New Member

    Joined:
    Dec 23, 2012
    Messages:
    1
    It might be good for him to have some people with diabetes around his age to talk to?
     
  10. nanhsot

    nanhsot Approved members

    Joined:
    Feb 20, 2010
    Messages:
    2,626
    I agree with this, begin checking meter and pump on a regular basis and have a daily meeting of sorts to discuss. Do this in a non confrontational, concerned but not judgmental way. Let him know ahead of time the plan so he's forewarned and doesn't feel cornered or whatever. Every day at some preset time you scroll through numbers and discuss issues, give suggestions and assist with problems.

    I think the most important thing is NOT to make a huge issue out of it. My son (18) gets pretty defensive and has begun not wanting my input. This is all normal and necessary but very hard for me.

    Good luck.
     
  11. Kaylas mom

    Kaylas mom Approved members

    Joined:
    Apr 14, 2010
    Messages:
    1,306
    We are going through some similar things, but not to this extent. I have been just taking her meter and looking at when she is checking, which is not very often.. and then checking myself. Obviously it has become too much to handle and you need to step in. I hope things get better.
     
  12. Amy C.

    Amy C. Approved members

    Joined:
    Oct 22, 2005
    Messages:
    5,560
    Not that this is particularly helpful now, but my son was very resentful at times when in high school and I tried to talk to him about diabetes management. When he went to college and had some issues with high sugars, he listened and tried what I suggested. I never said anything different. He was ready to learn.
     
  13. mocha

    mocha Approved members

    Joined:
    Feb 27, 2011
    Messages:
    430
    I am willing to admit that I used to be one of those "non-compliant" people, especially in my teen years.

    First of all, do you know why your teen is skipping checks and boluses?

    For me, I know it was a serious case of depression mixed with a lot of personal stuff.

    It is worth while to figure out why your teen doesn't do all the checks and boluses, that way you can attack the problem at it's root.

    Secondly, taking away the pump is a huge no-no. You should never ever make a threat like that to a patient. Your doctor is there to help you succeed, not threaten you. With the pump, at least basal insulin is still flowing. That is at least keeping it from being more terrible than it could be. If your teen is forced to switch off the pump, I'm willing to bet that the basal insulin won't be taken at all. You'll end up with many trips to the ER much faster.

    Third, try talking to your teen about ways you might be able to help. Ask them what support they need. Let them come up with ideas that will work for them (and for you).

    I'm sorry that you and your teen are going through this. I hope you both can find a solution that works well for you.
     
  14. Lee

    Lee Approved members

    Joined:
    Oct 5, 2006
    Messages:
    9,633
    TT1 teens and T1 suck. You have to be vigilant. Right now we are facing something similar with lack of testing at school. What do I focus on? Do I argue everyday until I am blue in the face about how important it is to test during the day at school or do I focus on testing and correcting when she is home?

    I focus on testing and correcting after many failed arguments. She is also on Lantus (as well as pumping) and she gives her shot in front of me every night - this way, I know she won't get ketones.

    It sucks. It is hard for them. It is hard for us parents. It sucks. But just like we have to watch out for all kinds of signs for drugs and drinking and other stuff, we also have to be viligant on T1. No dropping the ball here as a mom or dad of T1 teen.
     
    Last edited by a moderator: Feb 14, 2013
  15. Jeff

    Jeff Founder, CWD

    Joined:
    Jun 1, 1995
    Messages:
    1,544
    Lee's suggestion to use Lantus is excellent and will help to ensure that there is no DKA. Very important.
     
  16. Darryl

    Darryl Approved members

    Joined:
    May 8, 2008
    Messages:
    4,313
    I agree completely. Also as Kirsten mentioned, the reason why he does not attend to it are important. If the problem is that he doesn't want to do D stuff in front of anyone, then a shot of Lantus each day would at least provide some safety zone. I would also ask him if he even wants the pump. Maybe he doesn't. Maybe getting rid of the pump and taking a few shots a day using insulin pens with the ultra-tiny needles would actually be more attractive for him.
     
  17. arlene22

    arlene22 New Member

    Joined:
    Jul 16, 2007
    Messages:
    1
    Also struggling with this...

    My 17 year old daughter also has 10+ A1c's. We have tried so many different approaches. We have tried bribery and punishment. Nothing changes. She is such a good kid-- never gives us a moment of trouble in any other way. But she absolutely refuses to take care of her diabetes. Skips tests and boluses regularly. Lies if asked, and then gets insulted when I insist on checking the meter/pump myself. I do check her every morning and night and even overnight. I can't imagine what her A1c would be if I didn't. She/we have been seeing a therapist for two years, with no breakthroughs on that front. We switched to a new endo a year and a half ago who has a reputation for being good with teens. He says that her numbers are off the chart and he has never seen anyone with numbers like this, which frankly leaves me despairing, but also wondering if maybe we should be seeking help from someone with more direct experience with teens in denial. Sorry I don't have any words of wisdom-- just empathy...
     
  18. obtainedmist

    obtainedmist Approved members

    Joined:
    Aug 3, 2010
    Messages:
    1,537
    I might be missing something, but I don't understand how Lantus would help. Unless he actually disables the basal function in the pump (and then it would beep mercilessly) isn't he getting his basal amount through the pump even though he's forgetting/refusing to bolus for carbs? Wouldn't the adjusted basal rates on the pump keep him lower than one shot of Lantus if his needs are quite different during the day? I could understand if he isn't refilling his cartridge when he should...that would make perfect sense then!
     
  19. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Hi,
    I am just a bit older then your daughter but I went through the same thing when I was a bit younger then her (though not for as long or to such a large extent...). Anyway, feel free to PM me if she wants someone to talk to (email,phone, facebook etc) . I am away at school right now but from NYC (uws) so if you guys wanted to meet up for lunch or something I would be happy to do that as well when I am home.

    Best wishes,
    Meg
     
  20. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,652
    So why not a shot a day of Lantus in the morning? You give a bit more than is needed, so it's pulling her down all day and will help cover the day's carb intake..
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice