Since we last saw our diabetes team in late November my 14 y/o son has been progressively low and it's getting worse and worse every month. I'm in contact with his nurse and we have reduced his Omnipod settings almost weekly for the past 2 months. We have his regular appointment with his team on Monday so, no worries for getting care but I wanted to ask the community here if anyone has ever seen this or knows what may be going on, if there's something I should ask his doctor about. Some background: Dx'd in 2011 Omnipod since 2015 At least 4 verifiable bg checks per day No recent medication changes, (Novo rapid, concerta, citalopram, respiradone) no change to activity (pretty seditary). Has a solitary kidney with good function, Autism and ADHD as well as depression and anxiety. Stressed out but has always been. Has positive antibodies for thyroid but last summer labs showed it was still functioning fine. No other symptoms or recent illness, no flu no colds. He has 2 to 3 lows per day. His total daily insulin intake has gone from 60 units in November to 40 units now and he's still low. It's like we just lowered his basal or carb factors and by the following week he's low again. Today he was running a -20% basal and was low 3 times and that basal was just adjusted last week by his Nurse..... Any suggestions or just keep at it and see where he finally ends up.
If anyone is interested here's what it turned out to be. Diabetes burn out. He was faking 90% of his tests for the last 3 months. I only caught onto it when I realized we had far too many test strips in the cupboard. I've taken control of all his testing for the time being while he awaits an appointment with his psychiatrist. His Endo is following up in 1 month and we're doing everything we can to support him through this. Glad we caught it early, his A1C is 11 My advice is to always expect the unexpected and to learn how to distinguish manually inputted numbers in the Omnipod PDM if you have one.
Have you considered a Dexcom CGM? This has decreased my daughter’s fingersticks down to an average of 2 per day. This may be helpful in putting a dent in your son’s burnout.
Thanks for the recommendation. Unfortunately, CGM's are basically the only thing we don't have coverage for and are also way out of our budget but we're starting him on the Freestyle Libre tomorrow which will hopefully help him since most of his issues seems to be with the hassle of finger pokes.
Taking over the testing will likely be helpful. It is stressful to be a teenager with diabetes. The counseling can be helpful too. I felt that when my child went, she just told them what they wanted to hear or what she thought they wanted to hear & idk if she really got a lot of out it. A lot of what helped us get thru the teen years was learning to give them control over food & not trying to micro-manage everything, which as parents, we usually do. hang in there.
I think you're right. I've already noticed a big change in his demeanor just from not having to test himself. He seems a little lighter, slightly happier.
