Scared For The Health Of A 19 Year Old Type One Diabetic! Please Help

Get him to a doctor ASAP! He’ll probs need some monitoring and put on a sensible regime to regulate his bgs but I suppose the biggest obstacle will be for him to agree to get help.

Hi @Zaquellyn Are you in the UK ?

Carrying on this way isn't sustainable, something will give eventually, in the meantime by not taking control of his t1 he's not helping himself as his high blood glucose levels will be causing damage. I am pretty sure that he wouldn't like a visit to A&E or a hospital stay but this is where he is taking himself.

It's amazing that you are prepared to support him but he needs to help himself and admit that he needs help, can you sit down with him and have a heart to heart about this ?

Hi Zaquellyn

It sounds like he is rebelling against the diabetes by not testing his blood. Trying to show that he is in control and not the diabetes. Unfortunately by doing this he is letting the diabetes win.

Get him to a doctor specialist NOW It's probably the diabetes but there might be another issue.

You said he is looking skinny. I'm assuming he is loosing weight then which would suggest he is not getting enough insulin and his body is burning itself up for fuel. With not getting enough insulin his bloods will be constantly high. Which messes up your body so nothing is right and it gives you problems including those described.

You should also look up the term ketoacidosis. Left like this too long can result in death.

Sorry I don't mean to scare you but this might be what is needed to help your boyfriend.

Can you speak to his family? They might be able to get through to him.

Both my sister and I have diabetes. My sister rebelled badly. I not really. 15 years later she is the one one that developed the eye retinopathy and all the nerve issues ( can't remember the name for it). Meanwhile I'm lucky it's just my cholesterol with lots of the good stuff that is high.

I hope you get things sorted and the group are always here to give advice.

Ermintrude.

Hi @Zaquellyn , maybe you could show him this, but if he carries on in denial and ignoring his diabetes, things could get very much worse. Sending you both a big hug and he is lucky to have such a loving, caring partner, finger's crossed for a brighter and a happier future.
For anyone going through tough times regarding their diabetes management and from reading on the forum how some younger type 1 members really, really struggle, this is a must read for all.Remember you are not alone.

Connecting people with diabetes

Putting the Brakes on Diabetes Burnout


Helen Edwards; Founder and Director Diabetes Counselling Onlinewww.diabetescounselling.com.au
Diabetes burn out is a common problem for many people, but what is it? Basically this occurs when you grow very tired of managing your diabetes. You might experience feelings of exhaustion and instead of sticking to your regular blood glucose checks, medications, exercise, insulin and other self care tasks, you only do them partially or possibly neglect them altogether for a period of time. It is more than just having a bad day. You just can’t seem to muster the motivation to keep on managing and the guilt and stress about what this is doing to your body just builds up…..adding to your distress.

The challenge for people living with diabetes and this includes family members and caregivers, is to walk the fine line between stress and worry about diabetes, with feeling comfortable about where diabetes sits in your life. You need to try and have perspective about what your goals are and what you can realistically manage at this moment. When you balance this you are able to better manage under times of stress and prevent burn out. One of the biggest things that can help is to have good support. This includes from family, friends, other people with diabetes and your health care team. Exercise and relaxation strategies really help. Learning mindfulness, which teaches you to worry less and be present in your daily life helps to reduce anxiety and distress. Being able to feel in control and have a tool kit for what to do when things feel like they may be getting out of control in any aspect of your life really makes a difference. Diabetes is not just about your blood glucose and stress and problems in other areas of life will have an impact on you control. So it is important to make sure you stay healthy in all areas of your life and keep on top of stress.

Diabetes is different to other chronic disease as it requires self management by you on a daily even hourly basis, with guidance from your health care team. It can be easy to become overwhelmed by all the tasks you need to do and the day to day effort needed to manage. Burn out is particularly likely if you work really hard at managing your diabetes but the results are not what you would like. It is also more likely when you have pressure or stress in other areas of your life that you feel you can not control. Diabetes burn out can last a short time, be ongoing, or can come and go. Studies have shown that a majority of people living with diabetes do experience worries, fears and negative feelings at some stage. Some high risk times where you may experience burn out due to added stress or changes in your life include:

1. If you are not meeting diabetes targets, frustration with lack of movement towards your health goals
2. Experiencing family/relationship problems, breakdown or violence
3. Transition or times of change in your life
4. Loss of someone you care about or other grief/loss
5. Experiencing poverty or homelessness
6. Drug and alcohol problems
7. Problems with work and financial stress
8. Other physical or mental health problems – such as another chronic disease, depression, mental illness, eating disorders
9. Pregnancy – planning pregnancy and trying to conceive, during pregnancy and parenting when you have diabetes yourself
10. Growing older and dealing with changes to your body, your health and your diabetes
11. Diagnosis of diabetes complications

The recent 2011 study Diabetes MILES which surveyed over 3000 adults with diabetes in Australia found that overall, people were least satisfied with their health, as compared to other aspects of their life. Adults with type 2 diabetes who were using insulin had lower levels of satisfaction across all life areas (e.g. health, relationships, safety, standard of living) as compared to adults with type 1 diabetes or with those who had type 2 diabetes but were not using insulin. Adults with type 2 diabetes who were using insulin were also more likely to experience moderate to severe symptoms of depression and anxiety than other respondents. Moderate to severe depressive symptoms affected 35% of adults with type 2 on insulin, as compared to 22% of those with type 1 and 23% of those with type 2 who were not using insulin. Moderate to severe anxiety symptoms also affected 19% of adults with type 2 who were using insulin, as compared to 15% of those with type 1 and 14% of those with type 2 non-insulin-managed diabetes. Adults with type 1 diabetes were more likely to experience severe diabetes-related distress than other respondents. 28% of adults with type 1 diabetes experienced severe distress, as compared to 22% of people with type 2 insulin-managed and 17% of type 2 non insulin-managed diabetes. The most commonly reported problem area for respondents (consistent across diabetes types and treatment regimens) was worrying about the future and the development of diabetes related complications.

Rates of diabetes related distress are high yet people are often scared to ask for help, particularly if they have not been managing well. It is important that you DO ask for help and remember there is no such thing as a silly question! Most of us get tired of doing everyday tasks and diabetes sure adds to those! Few people can maintain all the tasks of diabetes care week-in, week-out AND keep blood glucose and HbA1c’s in the narrow target range all the time. Without realistic expectations and practical strategies for managing the thoughts, feelings and emotional side of diabetes, the risk of burnout is higher. The way we think and talk about diabetes has a major impact on how we feel and manage diabetes. Using words like “ high and low” blood glucose instead of “good and bad” can help and so does using CHECK instead of the word TEST when talking about blood glucose monitoring. The reality is most people have an immediate reaction to a high or low BGL. That is normal and fine, but once you have this reaction move on to looking at the number and working out how to manage this and prevent it in the future if possible.

Seven Steps to dealing with Burn out

1. Consider what particular areas of diabetes are causing you problems – usually it is not all of it! Then develop steps for sorting these areas. Get help if needed.
2. What else is happening in your life that might be conflicting with diabetes care, or making it harder?
3. How might you address these things?
4. What are your expectations for your diabetes management? Do you need to lower or increase your expectations?
5. What sorts of thoughts and feelings are you having about diabetes/
6. How are you managing these and are these strategies working? What have you tried?
7. Do you have any support? Is it the right support? Is it enough support? If not, how can you get this?

Support is vital. Make sure you get this from a variety of sources:

• Health Care Team
• Family and friends
• People with diabetes
• Online and in person
• Books, magazines and other sources of information
• Counselling and other specialists
• Take time out from diabetes and other stress – try to be a “human being” not always a “human doing”!

Diabetes might thrive on maths – to be corrected and added up BUT You are not a maths problem! See yourself as a sunset – not something to be solved, but appreciated –your achievements, attempts at change, dreams and goals – sit back and appreciate them from time to time and remember there is more to life than diabetes.

It does sound like he's rebelling, which is sort of understandable, as diabetes took control of his life at a time when he would have wanted to be exploring the world. So it's easy to see why he feels as if it's something that is controlling him, and he doesn't like it.

Even now, though I've had it for years, when I go for a hospital appointment, I leave feeling as if I've been turned into a child, and not an adult. I do recover, but it takes a couple of hours.

I think @Robinredbreast gives good advice. I think you have to find a way to get him to do what he needs to do, but at the same time allow him to feel in control of the situation.

Try using manipulative language like "I know you are clever/strong/whatever enough to win this fight, and control your blood sugars". That sort of language, play coach, use "you can win" type language, to give him a sense of power, and maybe try to shift it from a sort of childlike "you must do this because" to more of an adult "this is a challenge, but I know you can do it, sort of thing" so that he feels like he's in control of it.

That's just a thought. As for food, cook as healthy as you can, but again make sure he feels he is part of the decision making process.

That's me guessing, but obviously you know him, and I don't/

@Zaquellyn you say your boyfriend has stomach issues. Has he been tested for coeliac disease? Obviously his diabetes control isn't what it should be and his weight loss could be due to this, but coeliac disease is found in around 10% of Type 1 diabetics, and can cause stomach issues, weight loss and feelings of exhaustion.

Diabetes is about 90% mental and 10% physical so having the right motivation is key to successful management., If you've got a stubborn donkey then you can either give it a stick or a carrot, the stick may well get the donkey going but it will soon enough stop, whereas give it a carrot and it will keep going, words of encouragement are a must when dealing with a health condition.

Hi @Zaquellyn,
It is great that you care about him. But he is a young adult now. It is his condition and his responsibility.
Having said that older adolescents like him do rebel and be angry at the world and the restrictions that diabetes cause.
He may also have some so-called friends who are unhelpful.??
I assume he has been offered counselling and probably has not found it helpful or has declined it.
And I am not sure whether going as a volunteer on a young kids diabetes camp would help or not. Young kids managing their diabetes can be an inspiration.
With his erratic use of insulin at times he could also be at risk of losing his driver's license, if he has one. That sort of risk might make him sit up and pay some attention. His blood tests done every 3 months or so will give doctors a pretty good idea of what his control is like and therefore he may not be able to con them into giving his license back until he is 'behaving '.
Until he has near normal blood sugars for a number of weeks he will not really be able to appreciate how much better he can feel and how much his poor control is affecting his health - like not gaining weight, being tiredness, lack of sexual performance etc. So Catch 22.
And I agree with @dancer, his weight troubles could be due to poorly controlled diabetes but also to something like coeliac disease.
Even just on the issue of his weight his doctors need to be concerned.
It may be that the clinic has thought that the insulin pump is the best way they can give him some treatment but without more active remediation he is at risk of losing work, his health etc.
You also need perhaps to see your own doctor and maybe consider counselling. A relationship can only really work if both parties are prepared to work on it. You seem to be putting out and investing far more into the relationship than he is. Both of you have responsibilities and you risk being dragged down by him if he keeps up his present behaviour.
I hope he 'comes around' to doing his part

Folates. Go searching for foods that are high in folates. Most fruits and vegetables, and meat, contain them, only some have more than others. Vitamin B9 is good for cells. This research shows that supplementing with Folic acid, and B6 reduced endothelial dysfunction in children.

https://www.ncbi.nlm.nih.gov/pubmed/16818571

Foods like brussels sprouts, and peas, and also legumes like chick peas, have lots of folates, and other minterals, that you can secretly feed him. Also try and keep the carbohydrates reasonably low, and loads of veg, then you will also feed his gut microbiomine, with lots of health fibre, without his knowledge. Just go crazy with the plants.Salads too, lots of them.

If he doesn't like the pump it might be worth having a very long acting basal insulin like Tresiba. I read something somewhere, can't find it now, about one health authority recommending it for people who are irregular in their injections.

........................then you will start looking so healthy and fit, that he might realise he has to try a bit harder to impress you.

Zaquellyn said:

My boyfriend, 19 years old type one diabetic, diagnosis at 13. About 6ft '2 about 135/140lbs. Absolutely hates, and RARELY test his blood sugar. And guess-ta-mates the amount of insulin when he does dose... #1 concern!! He is starting to look really skinny!
He has extremely bad stomach issues all the time, spends a lot of time in the bathroom. Or making trips back and forth. He has lost all sex drive, and says its cause it takes all his energy and he never feels good after. He struggles to be happy. He says he is constantly upset and angry. We recently got jobs, night shift. I am really very worried about his weight, and sparatic dosing, mental, and physical being! Pleaseee help. What can i do, to help? What food should i make, what supplements, vitamins do get?!?!


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Zaquellyn said:

My boyfriend, 19 years old type one diabetic, diagnosis at 13. About 6ft '2 about 135/140lbs. Absolutely hates, and RARELY test his blood sugar. And guess-ta-mates the amount of insulin when he does dose... #1 concern!! He is starting to look really skinny!
He has extremely bad stomach issues all the time, spends a lot of time in the bathroom. Or making trips back and forth. He has lost all sex drive, and says its cause it takes all his energy and he never feels good after. He struggles to be happy. He says he is constantly upset and angry. We recently got jobs, night shift. I am really very worried about his weight, and sparatic dosing, mental, and physical being! Pleaseee help. What can i do, to help? What food should i make, what supplements, vitamins do get?!?!


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This is really interesting as my 20 year old son is REALLY struggling with all you mentioned too. Plus an eating disorder and severe depression. My heart goes out to you. Also, thank you for caring x. Keep me posted please.

Zaquellyn said:

He hasn't responded well to my heart to hearts. He doesnt like to be worried about. He had been hospitalized 5 times over the year 2017... I want to know what type of vitamins, foods ect. That i can get him, to help with the stomach problems(bowl issues) ,exhaustion ect... if he won't take care of it the right way, can't i prevent it from being worse

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If he's been hospitalised as many times as this in the last year then he is going to worry you, I would be feeling pretty anxious with worry if this was my partner. This also means he's not controlling his bg levels at all and letting them run high and sadly no amount of vitamins is going to help if he's running high, high bg levels cause anxiety which will worsen his stomach issues, getting control again is the only way forward.

Does he meet with his diabetes nurse regularly ? He can get a referral for counselling by speaking to his team, this is a starting point.

There is a reason behind his behaviour, so rebelling, feeling burnt out, he may have a needle phobia, there are a number of reasons, he just has to open up and he needs to ask for help, it has to come from him, if he wants to improve his health and ultimately his quality of life then he needs to open up and admit he's got an issue, is there any chance he can do this ?

Focus on the positive impact of good control if he's not opening up, point out he can help resolve his stomach issues by getting control, avoid hospital visits, feel clearer mentally, a pump is a pretty useless tool if it's not used properly, focus on getting him to take insulin regularly with meals. He doesn't have to think about tomorrow just focus on one day at a time.

Hey Zaquellyn
Kudos to you! I didnt get diabetes until 19, so I never had to go through the emotionally traumatic teenage years with it.
Tell him to wear and use his pump with pride. This is keeping us alive until a cure is found. Another attitude we have to develop is: We are controlling our diabetes, not it controlling us.
On the vitamin side look online (because they are hard to find in a pharmacy) for methylated multi B vitamins. This can be better absorbed in an already dysfunctional gut. I had a depression session a while back. Between bouts of weeping it clicked that I hadn't taken a B vitamin, of any kind, in 3 months. Out to the cupboard I shuffled and grabbed a 200mg of standard B6 and a 1000mg of Methyl B12. PLEASE NOTE I'M NOT SUGGESTING DOSAGE SIZES, only telling my story. Its effect was like having a warm wave wash over you. I live in Queensland, Australia. The change was immediate for me and I don't intend to ever stop taken my vitamins.
Haven't found out what causes it but I guess that the pancreas may help in the metabolism of some vitamins and since this doesn't work, we need to get more in our diet from an easily absorbable source.
Diabetes is a little like the Secret Service. Everday another sniper pops up to take us out. We can't duck for cover, we have to send that sniper packing. Another fight is won!
All the very best, you're leading a winners team.

Zaquellyn said:

My boyfriend, 19 years old type one diabetic, diagnosis at 13. About 6ft '2 about 135/140lbs. Absolutely hates, and RARELY test his blood sugar. And guess-ta-mates the amount of insulin when he does dose... #1 concern!! He is starting to look really skinny!
He has extremely bad stomach issues all the time, spends a lot of time in the bathroom. Or making trips back and forth. He has lost all sex drive, and says its cause it takes all his energy and he never feels good after. He struggles to be happy. He says he is constantly upset and angry. We recently got jobs, night shift. I am really very worried about his weight, and sparatic dosing, mental, and physical being! Pleaseee help. What can i do, to help? What food should i make, what supplements, vitamins do get?!?!


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Dear Zaquellyn,

I'm so sorry to hear of your boyfriend's troubles.

Believe me, ma'am, his troubles have NOT ended there. With his poor control of his diabetes, things WILL get worse.

Sadly, unitl such time as HE decides to take things seriously, his condition WILL continue to deteriorate, and he MAY need more than short hospital stays before he 'catches on'.

Your reporting of him spending "a lot of time in the bathroom" indicates that his blood sugar (glucose) levels are VERY LIKELY way out of control. This, unfortunately, is causing irreparable damage to his internal organs, blood vessels, and nerves. All of this leads to the development of diabetes-related complications, some of which can be a real pain (neuropathy), some which can prove embarrassing (erectile dysfunction, lack of control of bowel and bladder function, etc.) , and some which can prove fatal (heart attacks, strokes, total kidney failure, etc.)

Although coeliac [celiac, for our American cousins] disease has already been mentioned, and this MAY be a factor as someone that has one immune condition (type 1 diabetes in the case of your boyfriend) is more likely to go on to develop other immune conditions, of which coeliac disease is just one of several, I am more inclined to believe that your boyfriend MAY have already developed autonomic neuropathy, which is nerve-ending trouble that affects things that are normally taken care of 'automatically' by the body. This type of neuropathy can affect things such as sexual function, blood pressure control, temperature control, digestion (this has its own title, called gastroparesis, which affects how efficiently stomach contents are passed through the digestive tract). There are various tests that would need to be carried out to either confirm or refute this.

When you say "He struggles to be happy. He says he is constantly upset and angry." This MAY indicate that he is suffering with depression, and this is understandable for someone that has been diagnosed with a chronic condition, but it really is not helped by his poor attitude towards controlling his diabetes ... something that he DOES have some control over.

Your boyfriend's lack of weight MAY be due to his body's 'make-up' but it MAY also be due to his poor diabetes control. When insufficient insulin is being injected/pumped into his body, glucose can not be utilised [utillized] efficiently so the body's cells believe that they are going through a period of starvation. In a deliberate attempt to stay alive they look for an alternative source of 'fuel'. Fat and muscle tissues are used as this source of fuel. In type 1 diabetes AND some type 2 diabetics, this is where they develop diabetic ketoacidosis (DKA) and require hospital admission for emergency medical attention. (DKA is considered a life-threatening situation, which is why hospital admission occurs.)

Unfortunately, Zaquellyn, the foods that you prepare are likely to have very little, to no effect, on your boyfriend, and the same with supplements and vitamins. (Some supplements and vitamins MAY help, but lack of those vitamins and nutrients need to be diagnosed as being deficient in the first place.)

I would suggest that your first port of call would be to convince your boyfriend that he should see his doctor and, if possible, go along with him. Try to convince your boyfriend to be 'open' with his doctor, AND to mention all of the things that you've told us about here. (Writing the things that he should discuss on a piece of paper MAY prove helpful so that he doesn't forget to mention something, but the chances are he will NOT mention everything, hence the reason I suggest that you also attend COULD be a good thing. Be aware, however, that this COULD encroach on what might be a good relationship as no-one likes to be told that they're not doing what they said/agreed they would do.)

You've received some useful information here, ma'am, from all around the world, and even though I don't know your or your boyfriend personally, I truly do hope that you can both 'move forward' to getting the help that you both require.

Lots of Love and Light.

Mick
x x x x
x x x

P.S. Please don't be offended, or alarmed, at the 'x's'. It's merely a logo, of sorts, that I've used for the past 40-odd years.

Hi again @Zaquellyn,
I wonder as other have suggested that he be encouraged to post on this forum.
Also is there a place for what is called an intervention.? (I write this merely as a suggestion and is not to be taken as medial advice or opinion).
You may have heard of this technique used for people with alcohol problems where their friends all arrive and proceed to point out the problems that the person's behaviour is causing. In his case it would be about his behaviour in regard to his diabetes management and consequences of continuing his current behaviour.
Yes, there is the potential for him to react and dismiss everything (and everyone) but if admissions to hospital, his disabling symptoms (which one imagines is or will threatening his ability to keep working) are not enough, then is there anything to lose by trying a form of confrontation?
As long as his present behaviour is continuing and is being supported in good faith by all of you there may be no significant 'emotionally corrective' situation which can or may turn him around from his self-destrucutive course.
Notifying his health team of such an attempt would, of course, be very important so that they can anticipate his response and have support available to deal with this.
Best Wishes !!