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obstinate Type1 son

2

262trudles

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My 20 year old son, diagnosed age 5, is refusing to inject himself with Lantus. He is injecting Humalog. Just had a bad weekend 5.5 ketones, high blood sugars and being sick. Bloods are back down and 0.1 ketones. He refuses to go to hospital and won't talk or contact his medical team. He knows all the dangers of high/low bloods and was begging for help when vomiting but now thinks it is all a big joke. How can I get him to come to his senses. Have spoken to him about changing background insulin to tresiba but is still not keen to inject 100 units.
 
262trudles said:
My 20 year old son, diagnosed age 5, is refusing to inject himself with Lantus. He is injecting Humalog. Just had a bad weekend 5.5 ketones, high blood sugars and being sick. Bloods are back down and 0.1 ketones. He refuses to go to hospital and won't talk or contact his medical team. He knows all the dangers of high/low bloods and was begging for help when vomiting but now thinks it is all a big joke. How can I get him to come to his senses. Have spoken to him about changing background insulin to tresiba but is still not keen to inject 100 units.
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Hello Trudles - welcome to the forum :)

It must be a huge worry that he's not taking his background, do you know why ? Also 100 units sounds like a lot, what is his current lantus dose supposed to be ?
 
Juicyj said:
Hello Trudles - welcome to the forum :)

It must be a huge worry that he's not taking his background, do you know why ? Also 100 units sounds like a lot, what is his current lantus dose supposed to be ?
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He won't do his lantus of about 50 units a day because of the pain it causes him. He started doing it for about two weeks at the end of last year then stopped. I tried to get him to split into morning and night 25units each but just ignores anything I say now. He dodges his appointments all the time. Thank you for the hugs much appreciated
 
mahola said:
I think all you can really do is reassure him, tell him you love him and tell him you're there for him whenever he needs support. You can't force someone to look after themselves, sadly. He knows the dangers; he knows what damage he is doing to himself. As a parent, it is incredibly hard and heart breaking.
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Thank you for your kind and wise words. I am sure one day he will realise.
 
If it's the volume of insulin that's causing him pain, then it might be worth asking about switching to Toujeo which comes in 300u/ml strength so he'd need only 16 or 17 units instead of 50
 
Welcome to the forum @262trudles

262trudles said:
Have spoken to him about changing background insulin to tresiba but is still not keen to inject 100 units.
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He won't need to inject 100 units if he only takes 50u now with lantus, do you mean his total daily dose (adding up both his basal and bolus doses) adds up to 100 units?
 
robert72 said:
If it's the volume of insulin that's causing him pain, then it might be worth asking about switching to Toujeo which comes in 300u/ml strength so he'd need only 16 or 17 units instead of 50
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Cant get him to go and see his diabetes team, even threatened to kidnap him, with help, and take him to hospital! Didn't go down well.
 
262trudles said:
He won't do his lantus of about 50 units a day because of the pain it causes him. He started doing it for about two weeks at the end of last year then stopped. I tried to get him to split into morning and night 25units each but just ignores anything I say now. He dodges his appointments all the time. Thank you for the hugs much appreciated
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So he first started using lantus in the summer, but he found it too painful and stopped taking it after only two weeks? What prompted the switch onto lantus? What basal was he using prior to this? Is any of that still available to him?

So presumably he has been running very high since the summer? When he says he won't go to the hospital or engage with his hEalthcare team are those decisions made when he is at seriously high levels? Sometimes having high blood sugar can do funny things to your thinking, it can make sensible decision making difficult.

I'm not sure what to suggest to say to him. There must be some reason why he has decided to cut off diabetes support right now when he really needs the support. Have you had a chat to him to find out what he is thinking?

Edit: just a thought, if his diabetic team suggested the change to lantus and he didn't get on with it that might be causing his resistance to the diabetic team? Ask him if he would see another diabetic specialist at a different hospital. There are loads of alternatives to lantus available, but he is going to have to see a specialist to get access to them and help him manage getting his levels somewhere around normal.
 
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noblehead said:
Welcome to the forum @262trudles



He won't need to inject 100 units if he only takes 50u now with lantus, do you mean his total daily dose (adding up both his basal and bolus doses) adds up to 100 units?
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Sorry its 50 units of lantus a day he needs to inject, got myself worked up and put the wrong amount down. His humalog he is quite happy injecting and is well over 50units a day, big appetite. Thanks for support
 
Not sure what to suggest if he is unwilling to speak with his diabetes team, there's an on-line carb counting course that may be useful to him if you want to take a look and pass it on:

http://www.bertieonline.org.uk/
 
Could he not then use his Humalog all the time then if he feels like that? Just means he needs to inject some before bed.

There are plenty of other basal insulin's though that do not sting so he needs to sort it out. He wont get told off by his team. Perhaps Mum needs to write to his consultant or DSN in confidence and explain what is going on. In some cases the DSN will do a home visit. His other option is to go on two injections a day as the mixed insulin will obviously cover him 24/7.
 
catapillar said:
So he first started using lantus in the summer, but he found it too painful and stopped taking it after only two weeks? What prompted the switch onto lantus? What basal was he using prior to this? Is any of that still available to him?

So presumably he has been running very high since the summer? When he says he won't go to the hospital or engage with his hEalthcare team are those decisions made when he is at seriously high levels? Sometimes having high blood sugar can do funny things to your thinking, it can make sensible decision making difficult.

I'm not sure what to suggest to say to him. There must be some reason why he has decided to cut off diabetes support right now when he really needs the support. Have you had a chat to him to find out what he is thinking?
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He was on an insulin pump up till Christmas last year. Then onto injections. This has been going on since then. I think it has all caught up with him and is now making him poorly. Thanks for your thoughts on the medical team and his thinking we have had lots of discussions at different times. Will continue to support and help as and when he accepts it.
 
When you say it's causing him pain - what type of pain is this ?

If it's injection sites then he can use his bum, more fat and easier for basal injections - if it's the insulin then is he using it straight from the fridge ?

Alternatively the pump is another option as this only used quick acting insulin, however he would need to really be on the ball with this which he'd need to demonstrate by working at getting the basal injections done and keeping his blood glucose levels down, but could be a thought to help him further down the line.

I know we aren't doctors but sometimes talking to other type 1's could get him motivated again, would he join up here and talk to others ?
 
262trudles said:
He was on an insulin pump up till Christmas last year. Then onto injections. This has been going on since then. I think it has all caught up with him and is now making him poorly. Thanks for your thoughts on the medical team and his thinking we have had lots of discussions at different times. Will continue to support and help as and when he accepts it.
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Just posted my reply and then saw this ! Why did he come off the pump ?
 
CarbsRok said:
Could he not then use his Humalog all the time then if he feels like that? Just means he needs to inject some before bed.

There are plenty of other basal insulin's though that do not sting so he needs to sort it out. He wont get told off by his team. Perhaps Mum needs to write to his consultant or DSN in confidence and explain what is going on. In some cases the DSN will do a home visit. His other option is to go on two injections a day as the mixed insulin will obviously cover him 24/7.
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His humalog is bring done at night and he is usually okay on it. I have spoken to his DN who is aware of how son feels and DN suggested Tresiba, its getting son to go in. Hr started on the mix insulin 15 years ago and did okay on that. Thank you for advice.
 
262trudles said:
Wasn't using it properly :(
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Ah ok - to be honest I know of another youngster who wasn't using her pump properly, she went back to injections and can now see the positives in using the pump so is keen to go back to it, he may change his mind over the pump. I think it's important to let him know there are options, but it's like leading a horse to water, if he hasn't got motivation to do so then it's finding out why he's objecting. Ultimately the desire has to come from him. As I said earlier would it help him to connect with other type 1's ?
 
Juicyj said:
Ah ok - to be honest I know of another youngster who wasn't using her pump properly, she went back to injections and can now see the positives in using the pump so is keen to go back to it, he may change his mind over the pump. I think it's important to let him know there are options, but it's like leading a horse to water, if he hasn't got motivation to do so then it's finding out why he's objecting. Ultimately the desire has to come from him. As I said earlier would it help him to connect with other type 1's ?
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I am going to try and get him to read all this and hope he will find it as enlightening, informative and as friendly as I have. Thank you all so much.
 
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