Need help and advice

Kids are always difficult as it's a fine balance between allowing them to be children and taking care of the diabetic side without standing them out from their peers...

There is nothing wrong with chips, pizza's etc as long as it's in moderation, and that is the keyword Moderation..

It sounds as though with 2 injection's a day he's on a mixed insulin, which combines the long acting (background insulin) with a quick acting insulin, to get this to work well you do need a strict regime of carbs through out the day matched to the insulin, not idea for the dymanic world of a 10 year old.. As it offers very limited flexibility..

She be far better of asking to go onto MDI (multiply daily injections) the downside does mean that it involves more injections, but because you injecting the background seperately and quick acting insulin for foods being eaten, it is a lot easier to adjust the quick to suit the amount being eaten at any one time, and make correction in the dose that reflect his activity levels i.e he's been to footie practice it may be that when he has his tea, on this night he needs a lower carb-insulin ratio to prevent an hypo... or at dinner time he needs a lower ratio due to having P.E in the afternoon etc...

As to eating habit, well I'm afriad it is likely to be a slow and frustrating process for his mum, to encourage healthier eating practices, a fussy eating kid are a nightmare at the best of times..

But if she looks around at website such as the splender one, there are a lot of recipe's about that can make foods such as cakes and biscutes etc more diabetic friendly..

And for things such as chocloate bars, well there is a place for these either as a occasional treat, or offered when he's doing some exercise again before or after footie etc where he's going to be burning of the sugar from them..

I developed T1 as an adult and for me It was very scary suddenly thinking that my your whole lifestyle had to change (actually for me the changes were less than I thought they would be but I was already eating my veg and fruit :wink: )
A healthy diet for someone with T1 is exactly the same as a healthy diet for anyone else. but telling a teenager what is good for them is as I'm sure you realise, often counterproductive.
His diet can be built upon. He can continue to eat carbs and I'm sure he will have been told that no food except perhaps full sugar coke is forbidden. Some foods however, are far more difficult to dose for correctly and his present insulin regime is inflexible. (see below)
It sounds as if his mother doesn't do much cooking herself. There are many healthy foods that appeal to most teenagers. Grasping at straws a bit, but there are several cook books aimed at teenagers. I'm not suggesting that you give it him, though you never know he might like to cook himself but maybe one might help Mum. (one that comes to mind is Real Food, Real Fast by Sam Stern) Obviously books like this won't be aimed at people with diabetes and a few of the recipes might be too high in fast sugars/fats for his insulin regime to deal with but most seem to have half an eye on a healthy eating.
He needs to accept his diabetes and learn to manage it for himself. There is a book that many parents and young people (and older ones) find very useful
Type 1 Diabetes in Children, Adolescents and Young Adults: How to Become an Expert on Your Own Diabetes Ragnar Hanas. It will certainly help the parents and it maybe that he will be able to get something from it himself.
Unfortunately, the twice daily insulin works best with a fairly regular lifestyle with consistent meals . Many doctors (in the UK) seem to put people onto this at first Often people find they do better on a regime that involves 3-5 injections a day. This allows them to dose for meals separately and to vary when and how much they eat. This fits better into most peoples lifestyle (as do pumps which more young people are getting) but I would think he will now need time to come to terms with things before making what might seem to be a drastic change

HI Karen
You are not wrong, a carb-only diet is no good for type-1s, and as you know not for type-2s either.
Many patients are given what I consider bad dietry advice about carbs from dieticians in diabetes clinics- my brother in law is such a person, and unfortunately/naievely believes everything he is told., but it's human nature to trust the "experts" even if they appear to be anything but :?

It must be really stressful for your friend, but her son is 14 and not 4 and he will have to take responsibility for his own diabetes /diet and realise that he's endangering himself by eating the wrong things. I don't envy your friend's situation, it's hard with teenagers at the best of times, everything you say can sound like your nagging
I'm in a situation at the moment with my 18 yr old - trying to peruade him how bad spending too much time on the computer is for him. When he's been on it for long periods, playing games, etc; I notice a change in his character, he gets angry, depressed and it's starting to affect him in a big way. He's become very insular and reluctant to go out on his own, he is also disfigured. I've made a decision this week to seriously restrict his internet access for his own good and I hope it works and he realises I'm not out to spoil his fun, but to improve his quality of life. Also encouraging him to come out running with me, which he does enjoy thank goodness, and realises that physical activity DOES make him feel better. I feel guilty because we indulged him when he was going through cancer treatment but for his sake I've got to rectify it now, so he can lead a more normal life now his health is better, although I know as the bad guy I will bear the brunt of it
He's got worries that most kids don't have, and undoubtedly your friend's son does too, even if he doesn't express it. The psychological issues of childhood illness are a minefield. When your child's ill you want to do everything for them and it's hard to be hard on them, but sometimes it's necessary.
Your friend is very lucky to have you caring so much. Less knowledgable people can misunderstand and even trivialise diabetes. All my mother ever said to me following my diagnosis at 19 (even though I felt like a big kid!) was "oh well, millions of people have got it".
As Jopar said, I MD/basal bolus regime would be good as it will give him more flexibility and probably better control. It's hard if you're an active teenager to be restricted to fixed meal-times, a basal/bolus regime means you can choose when you eat. I was on a mixed regime to start with, but for that reason switched. It made me feel in control of my diabetes rather than it controlling me.
Jus x

Hi Karen,
It will be hard - yes, obviously he 'needs' a radical diet change, but he is a teenager who has been eating in a certain way for a long time, and he has a big shock of having diabetes.

From my experience of 2 teenagers with diabetes - age 13 and 16 I can say that i would concentrate on the checking blood sugars regularly as my priority for him. A lot of teenagers rebel against having the diabetes by not looking after themselves properly, not caring, and not being able to think about how that behaviour affects them in the long term.

They hate the fact they have diabetes, and want to stick their head in the sand and ignore it.

Going on at him about the diabetes and also the diet in my opinion will help to alienate him.

I think that the diabetic nurse should be a big help in sorting out his insulin requirement initially, and the most important thing would be to make sure he checks his blood sugars and does his injections.

Hopefully the rest will follow. At the end of the day if he can move onto multiple injections then at his age i would personally be okay with what he is eating as long as he injected the right amount of insulin to cover the amount of food.

There are too many battles with teenagers, and i wouldnt push this one. (just my opinion!)