child, 19, not checking blood sugars, a1c through the roof!

Hello all,
We are frustrated as parents. Our son just finished his first year at college. He has not been checking his blood sugar in the way he was when he was home - 4x a day. His sugars are in the high 300s or even low 400s when he does check them. What can we do to help he see the importance of checking his blood sugars and adjusting his insulin. He uses a pump.
thanks,
J and R

 

Well, every family has a different way of dealing with this type thing, and a lot depends on your son and how he reacts to information and such. My son does not do well when told what/how to do, and he can be very stubborn. Changes need to come from him, and need to be something he agrees to and wants to do or we're doomed to fail!

My approach would be to sit down with him as a family and discuss it rationally and calmly. To explain to him our concerns for his future health. Asking him why he isn't checking, how he feels at 300 and why he isn't being more mindful, etc. My son feels horrible when he's that high, and his grades would be suffering, so that would be part of my approach as well.

For our family college and grades are a priority, so if my son were living at 300+ I know he would not be making good grades, so that would be something we'd discuss as well. If he isn't keeping his grades up, then he needs to either get a job and go out on his own or return home to go to community college or a college within commuting distance. For our family there are rules in place that if you don't keep up your grades we reserve the right to withhold financial support and/or bring you back home. For him, I've seen a direct relationship between highs and lack of focus, poor grades, etc. So I would point that out and work to help him see that connection.

I might set up an appointment with his therapist, he sees one on occasion that is also T1. Hearing it from someone else always helps.

I would want to ask gently if he were drinking too much, and make sure he understands the risks of that.

For my family this would be a heartfelt confrontation, with the outcome needing to be either that he works to manage things better or he returns home for assistance if we are to continue to financially support him. If he chooses not to do either of those, then he needs to make plans to support himself. Ultimately he is an adult now, and he can make adult choices.

I would want to find out WHY he is not managing his health. The answers to that would then steer my future decisions and actions.

Good luck, this is a big fear of mine, my son is very independent but also can be rather lazy at times.

 

My kids are a ways off from college yet, but I agree with nanhsot. What sort of grades are you seeing? Are you helping to pay for college? If you still have anything to do with his finances or living situation, I would be revoking privileges. You can bet my DS will be seeing privileges revoked if he is not being responsible enough. My DS would have awful grades if he was in the 300-400's. His grades suffer when he's in the 200's.

Maybe one of the college kids will chime in here with some heart to heart conversation you could have that would be effective.

When I was in college, one of my close friends was (is) type 1. She was very quick and discrete about it, but she still was responsible. I'm not sure what motivated her to be responsible. No one said anything to her. You could ask if someone is causing him (making fun of him, snide comments, etc) to not take care of himself?

 

thanks

Thank you both for your replies. good points. our son's nurse at the diabetes clinic says that this is what happens at this age...
We do feel like we have some leverage - can withhold car, and college fees - as you say...
I wonder if any parents who have already lived through this age might comment too?
Or any young adults?
thanks again,
Joanne

two sons: one 26 in the army
one 19, type 1 since age 2 and 3 months

 

Unfortunately with most of us juvenile onset diabetes (or type 1) there will be a time where we just decide not to take care of ourselves. It does happen to most of us. And he's been a diabetic most of his life, so it may because he's no longer living under your roof he's decided he can do whatever he wants.

I did have a rebellious stage myself. Mine came about because I was tired of doing everything. See my drug abusing/alcoholic parents decided after I had returned from a week at a diabetic camp and learned how to inject my insulin by myself it was time for me to do everything without supervision at the age of 9. I had already been filling up my syringe and, but they had been checking to make sure it was at the correct level, getting my own breakfast. After camp, they refused to help me with anything. So when I was about 16 or 17, I decided I didn't care. I would check my urine and if it was 4 or 5 plus, I didn't care. I rarely changed the amount of insulin I was taking. I was tired of doing it all. I only saw my "diabetic" doctor when the family doctor found a problem. I think now it'd be called burnout. It lasted about a year. I don't have any complications.

 

You might want his doctor to have a frank discussion with him about high blood sugars and erectile dysfunction. That was what a parent I know with a rebellious 16 year old did. That information seemed to hit home.

 

Ok, my kid is only 14, so I don't know what the future holds and I say this only as conjecture.

I don't think that there is any one thing that anyone, a parent, CDE, RA can do or say that will coerce a 19 year old into doing what needs to be done. It's a bit late to withhold goods or $ or impose punitive measures.

But I do think that a straightforward conversation - as unemotional as possible and absent all judgement - should be had to discuss why things have gone off the rails. Perhaps there are logistical and management barriers that he's too immature to resolve on his own. Maybe he needs someone to come in and help him understand, from an operations perspective, how he can do the bare bones minimum to keep himself safe on campus.

I'm guessing that at home there were, however informal, systems and routines that helped him stay on track - perhaps the boundless freedom of college life has just made it really difficult for him to establish some simple routines of his own that are needed to fill that vacuum.

Good luck!

 

I agree with this. Once you're off track, it can be overwhelming to right the ship. Start with small steps and low expectations. Get him to do the minimum needed to keep himself safe.

Especially since he has a pump, encourage bolusing for every meal - even if he doesn't test. Try to get 2-3 tests a day. Before breakfast and before bed are the most key. Help him to adjust basals and ratios. Make sure he has the supplies he needs.

I personally think the pump is easier, but if he's overwhelmed by that, let him switch back to MDI. Sometimes just a change in regimen can be "interesting" enough that you pay more attention to diabetes for a while. College is a rough time to manage diabetes.

 

I am a much older adult, but did have a time in college where I veered off track majorly. I just need to agree with the other posters. I don't think holding back on paying for college costs is a great option. The car yes that is a good one, but my endo tried that one. I never went back to him after that appointment. I just have to say once you have veered off track it is hard to get the ship righted again. I am doing much better now, but this is a disease that just never gives you time off.
Wendy

 

I agree with the threats do not work. I am a type one diabetic in college and when I was in high school my family tired the scare tactics. My uncle was a podiatrist, and he had me watch him put a metal rod up a type 1 diabetic's foot. He also had me watch him amputate a diabetic's toe. Lets just say it did not work. Just show him love and support and ask him what you can do to help. Try to have a calm conversation about what he is going to do better and how he wants to be accountable for it. I find with me that if I feel like I have the control I am a lot more likely to follow through. Good luck

 

Hello jojouu:

All kinds of possibilities here... depends on which channel(s) you have used in the past to some extent. Lets start at the beginning.

TESTING, the act itself is still relatively new in the history. Before the mid/late 80's testing did not exist. There are many both here and elsewhere that never tested because it had not been invented yet. -Shrug- We are alive and doing fine thanks...

The testing obsession, many possess regretably does not guarantee an outcome. It may help, but there is no certainty here. Genetics appears to play a huge part too perhaps. Add that it hurts, it costs us our own blood, which myself I'm a huge fan of keeping in my own body thanks very much. Never been a fan. All of us do the very best we know how, and roll the dice. Get bad results enough and the process with time teaches despair. Not a great place to be... Diabetic long enough make numbers gnats on the windshield, something largely ignored or dismissed. But the readings themselves are just numbers nothing to panic over. Cope and keep going.

You can have conversations with us... but mandatory for such discussion(s) I contend is VULCAN DISPASSION. To get into our head you have to set aside the raw panic. In theory an adult, you'll need to talk with him as an adult. A young man. Drinking, sex, perhaps drugs, smoking who knows... all manner of things he may have been exposed to, had experience(s) with at school. If you want to have the diabetes conversation, you have to accept these possibilities.

Does he have a playmate/partner? Talk with them, if you dare. They too have "options" to nudge your son, if the relationship is strong enough.

You could openly endorse his dismissal... encourage it perhaps. A tune not many consider. Reverse psychology 101 with a serious side order of expert acting on your part. Hours after you get him that "HI", and he feels like dirt, then you ask him how he feels, tricked by his mom/dad.... setup in order to have a difficult conversation. A variation of the hangover game some play brutally on their kids knowing they are hung over wanting to teach them a lesson idea.

If you want to really start the conversation more testing, copy exactly what you hope/desire/expect him to do. Want 4 tests/day, they YOU perform 4 tests use generic strips, the cheap meter at the local pharmacy/store. Or simply prick your finger a minimum of four times per day for a week see what insight that provides. Gives a whole new perspective what you are asking....

DIABETIC VACCATION option.
For 72 hours you will take 100% control of his numbers and shots, eating just like when he was little. You dont talk about it, you don't discuss it until that time frame is over. Afterwards you have lots of things to discuss but in the meantime, you would like to give him a very intimate, very special gift, a vaccation. Afterwhich you will talk. His a** is yours for 72 hours and you will do it all.

A Standard cure for burnout....

Any of these useful ideas?