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Help for wayward t1 son who is ready to take control?

M

mirror

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My son (age 18, t1 since age 10) has had terrible control, doesn't inject novo(unless he feels bad), just lantus and doesn't test blood sugar.
We've had some bad health issues with his older sister some diabetes related for the last year.
He asked me for help yesterday to plan a month of meals in advance (I think week to week probably better to start) to 'help him budget and help his diabetes ' he said he's going to start testing. He is a chef (just in a pub, but likes experimenting,)and wants help to easily carb count his own recipes too. He eats a lot of meat, eggs, fruit, jacket potatoes. He drinks. He keeps irregular hours.
I know support with small changes are the key - he can't go from zero to great in one go or he'll fail. I suggested a course and diabetes team but he is vehemently against.
What suggestions do you have (ps he is severely anti authority, hospitals, appointments etc - he hasn't been to an appointment for years and when he did it was just lectures)
I know he will need to find some sort of baseline for the lantus and work out the ratio for bolus - easy Internet link anyone?) He partly wants low carb to inject as few times as possible. He's skinny not overweight ( - never has been)
He does currently drink full sugar squashes, juice, energy drinks and eat a lot of sweets.
 
Hi @mirror, if he truly wants to take control then he needs to cut out the full sugar squash, energy drinks and sweets. By their very nature, they induce rapid onset highs that are nigh on impossible to control with injections. That would be a big step in the right direction.

Then, to get things under control, he can start with a basal test. Here's a link: https://mysugr.com/basal-rate-testing/

This will help to get the Lantus stable.

I'd strongly recommend, in spite of his dislike of authority figures, that you somehow find a way to get him to a hospital clinic where the staff have been prewarned not to lecture and to provide a sympathetic ear.

There is also the BDEC course which helps to explain carb counting and how to work out ratios that may help you.

http://www.bdec-e-learning.com/

It might also be worth getting hold f the book, Think like a Pancreas for him to read. It's a good way to understand what's going on.
 
@mirror it sounds as if you can feel very reassured that your son has approached you in this way, as it means he has acknowledged for himself - and accepted - that he needs help in getting to grips with managing his diabetes. And that's a huge, huge step in the journey.

He will find a lot of support on this forum.

Small steps - finding a brand and flavour of sugar-free drink that he really likes would actually make a big difference pretty quickly - and a sympathetic ear at the hospital would go a long way (as @tim2000s has suggested, perhaps prewarning staff in advance of his appointment - I've done this before with my mother-in-law's health issues and they were amenable to my talking to them about her before they saw her).

Wishing you and your son all the best.

:)
 
mirror said:
and wants help to easily carb count his own recipes too.
Click to expand...

There's an app called Cook & Count which would be useful here:

http://www.cookandcount.com/

mirror said:
I know support with small changes are the key - he can't go from zero to great in one go or he'll fail.
Click to expand...

Small changes work best IMHO.

mirror said:
What suggestions do you have (ps he is severely anti authority, hospitals, appointments etc - he hasn't been to an appointment for years and when he did it was just lectures)
Click to expand...

It's important that he attends those appointments, the annual diabetes check-up not only measures HbA1c but also tests for signs of kidney disease through urine and blood samples that are taken, plus they also need to monitor other important things like bp, cholesterol and look for signs of Neuropathy (nerve damage).

The annual eye screening appointment looks for conditions that effect the eyes like Diabetic Retinopathy, undetected it can lead to sight loss and blindness (in the worse case scenario) if not picked up early, the earlier it is diagnosed the better the outcome and that is why he needs to attend these important appointments, by not doing so he could be putting himself at risk of complications further down the road.

Get him to have a look at the links Tim posted as they will give him a good foundation to help turn things around. Best wishes.
 
Thanks
I will show him the links and work on him ref appointments
His sister is having a series laser and injections in both eyes for macular degeneration and /or(?) proliferative retinopathy.
He has initially asked about menu planning and carb counting so I'll send him all the information and start with that.
 
Hello Mirror, i think mindset is about 75% of the battle with managing type 1, having the right mental attitude is key to good control. If he can start to test/inject etc and get better control then think about getting support for a pump, which would help him with his work/shifts and eating patterns. The NHS would want to see him doing better at his control before considering him so it's a chicken and egg scenario, but this would ultimately help him much more, but means being a bit more receptive to doing a DAFNE course and speaking to docs, so it depends how much he wants to do it himself.
 
I find the 'carbs and cals' app on my phone useful for working out carbs in food, it has photos of different portion sizes. I think a very rough guide of how much to bolus for meals is about 1unit for 15g of carb, but it can obviously vary person to person. Also it can vary depending on time of day. I've invested in a freestyle libre and it is amazing how seeing the line on the graph going up and down makes me focus and want to make changes. Good luck with your son and with your daughter's eye surgery.
 
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