September 18, 2002
Daily Care
Question from an RN in Las Vegas, Nevada, USA:
My 16 year old son, who has type 1 1/2 diabetes, just went off the pump two months ago because he felt it was taking over his life, and he also lost the nurse educator to whom he related well. He was placed back on Lantus (insulin glargine) at night with Humalog based on carb counting, but I am dubious that he is just speculating on how much Humalog to take since his sugars are high (over 300 mg/dl [16.7 mmol/L] at mealtimes), and he doesn’t seem to be using his bolus guide to calculate. He also refuses to keep a log (but he said “I” could), he as stopped exercising, and he refuses to go to a therapist.
We have an appointment in two weeks, but should I make an earlier one? How long can he keep taking whatever number of units he feels like? How hard will this be on him later in life? Any help will be appreciated. I don’t want to be domineering, but I can’t watch him slide down either.
Answer:
All good questions. The immediate health risk is no different now than in two weeks, so I think an earlier appointment with the endocrinologist will make little difference. Please do check him for ketones in the urine or blood as that would make a difference in the timing of contacting his health care team.
All-in-all, based on the above, this all sounds like a loud cry for help from your son, and despite his potential objections, I think a visit to start a dialogue with a mental health worker is in order.
DS
