Hi everyone, my 14 year (9th grade) son is not testing as he should and I just am at a loss as to how to make him do this. He wears an omni pod but when it expires he'll let it go and do shots until he feels like putting one on. I have tried nagging him which seems to only make it worse. He saw a therapist recommended by his doctor who pretty much gave him license to not test. She said as long as he saw his endo yearly they would catch anything that was happening! She also said I shouldn't bug him and be happy if he tested twice a day, I tried that approach and when I checked his pdm at the end of the week he had not tested for 4 day's!! His A1C is 12, I know he doesn't feel well, he's incredibly moody and his grades are suffering as well. Today I had to go to school to bring insulin because he didn't have it and wasn't wearing his pod, he was so high he didn't register a number on his pdm! If anyone can offer any advice at all I' m willing to listen, I have grounded him for the weekend for going to school without his pump or insulin. He is extremely angry with me, he is very social but I just don't know what else to do. Thanks for any insight anyone might have, I am one frustrated mom!

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This is a very difficult situation. I bet your son is at an age where he thinks he is invincible, knows better than his parents, does not want to feel different or excluded from his friends and might be suffering from burnout. You can encourage him to test and take care of himself, but ultimately he is the one that will have to do it. I think you need to work on changing his outlooks to get him to take his management more seriously. I have some suggestions and maybe one of them will hit home with him...

First off have insulin available at the school, in the nurse's office in his locker, just somewhere so that if he wants to take care of himself he can do it easier. Second see the endo 4 times a year. With an A1C that high he needs to see an endo who may be able to get him to take better care of himself.

Who is the main one in charge of diabetes management, him or you? Is he aware of all the ways/information to treat T1? He may benefit if you say something like, your becoming independent and in a few years you will be off on your own at college. I think it is a good idea for you to take control of your management and let me take a back seat. This may empower him. Also, you could schedule a meeting with a dietician, CDE, endo, etc. at this point to make sure he knows how to accurately care for himself.

Possibly some reward for testing and/or bolusing? A dollar per test no matter the result. If you do this don't criticize the numbers, just reward the behavior towards better glycemic control.

He could be the type of kid that just wants a break. He may find it very beneficial to see that you are on his team and he is trying hard. You could do this by compliments and positive reinforcement. Or getting his supplies out and ready for him. Or counting carbs for him when he is around so he can "escape" for at least a little bit.

I would also seek out other sources than his parents for him to learn, see or be around diabetics. Sometimes at that age the last person a teen will listen to are their parents. Weather its an endo to educate him, or a support group for diabetics, or a T1 camp.

Fear is also a big motivator for people and scare tactics could be considered. I am not a fan of this idea as it could easily do more harm than good, but for some it may work.

Good luck. I was a bit defiant in my teen years and my management laxed. This is, to some extent, normal T1 behavior but you are doing the right thing by tyring to help him be able to lead a long and healthy life.

Capin has some great ideas.
We have heard some great reports of help received from this organization

http://www.behavioraldiabetesinstitute.org/

Dr. Polonsky, their founder, is a good friend to us here at TuDiabetes, and will be speaking to us in a live interview Feb 15. please mark your calendar, I hope you can make it:
http://www.tudiabetes.org/events/live-interview-with-dr-william-pol...

personally I used to test as little as possible, because if I saw a high number, I used to think it was a like getting a bad grade. now I just try to think, "wow, glad I caught that now, instead of hours from now", and see if I can understand why it happened.

I'm not usually one for scare tactics,  but someone posted this the other day on Reddit and it seems quite relevant -

http://www.reddit.com/r/diabetes/comments/171stw/someone_pmd_me_and...

I can understand your frustration.  I am sure he's burned out and tired of dealing with this.  We all get like that sometimes.  I don't know if he would be receptive to this, but maybe you could take back some of the management for awhile to give him a break.  Would he allow that?  I've heard of parents doing this with teens....kinda like you do all the remembering to test (he just has to do it when you remind him) and counting of carbs. 

As someone with T1, I really feel for what he's going through. As someone who is no longer a teen, I feel for you because I can imagine how you feel watching him destroy his health. I can assure you that he doesn't feel well and will likely come around at some point.  Try talking to him....try to get him to talk about what it is that is making him not want to test.  Try to help him come up with some solution.  Tell him that you understand this stinks and is not a fair hand to be dealt.

Does he know any other teens with T1?  Has he been to camp or does he have opportunities to socialize with other T1s? 

I would look into suing the therapist for malpractice. I have a 14 year old and we are constantly feuding about stuff but I think that she respects that I'm in good shape with diabetes because I take care of myself a lot. 12 is very damaging. I have a long history but what got me going was seeing a few PWD obits in the newspaper, guys in their mid-30s, when I was in my mid-30s.

Grounding is good. Junior goes absolutely ballistic if we hint at phone grounding. Every now and then, that comes up and, after she goes berserk, it usually produces the desired result in short order. And we give it back and start over. For a while I'd say "she's not 13, she's either 20 or 6..." at some of the fits. The high school catalog seems to have snapped a lot into place too, as she suddenly started acting a lot more grown up and responsible. Maybe taking the approach of being grown up about it would help. "My evil mom grounded me from the computer until I make 30 friends @ Tudiabetes.org" might be an interesting thread...

I was just a very, very lonely teen in th 60's. No real testing (only TesTape.)No one was really aware, at that time, of diabetes in children. All anyone was worried about was a low blood glucose. which NO ONE COULD TEST FOR!!! Someone to talk to...not happening. Did I eat right, do the right stuff? Want to guess? I think I was utterly overwhelmed into my 20s when I met a wonderful guy who suddenly put a different spin on everything.

You want your child to be fantastic. He is struggling, obviously. I guess my questions are: Can you can fix it? As a child, I had to find my own way. Fun? Sometimes. Interesting? I was always learning, even at 10. Scary? Everyday and sometimes I scared the beejeepers out of myself and those who love me. Is it diabetes? Yes, sir. Can you change the reaction and mindset of a teen with this disease by restricting his life even further when he has such a mindbogglingly restrctive disease? Will that cause change or refusal. Lots of things to consider.

I would suggest you talk to the doctor, endo, and especially a pyschologist first. It will help you move forward confidently and courageously, to help your son.In the long run, he must find avenues to help himself.

My wonderful mother fought long and hard(and I mean fought long and hard!) to keep me involved in activities that wanted to exclude me as a diabetic. I am thankful everyday for the perserverence and wisdom she taught me.

I am a pediatric nurse and I see this quite a lot, which ends most of my kids in the hospital in DKA. But, I was one of these kids too, and I was just like your son. Any of us here who were dx as a teen can totally relate to what you both are going thru. Continue to support him but that doesn't mean allow him to continue to make poor choices. At 16 my parents completely handed any and all diabetes responsibility over to me, and it made me mad, and afraid and lonely, and I resented them for a very long time.
Even though we want our kids to be independent and take control, most teens are not ready to handle the responsibility that managing diabetes takes. Even though, he is 14, he is still just a kid. His age shouldn't give him an excuse, but developmentally, emotionally,he just can't handle it. At his stage of development kids think that nothing will even happen to them so they can't relate the future consequences to what is going on currently. He might be moody, what teen isn't moody, and not feel well now but that's not a significant or severe consequence that he can relate to his poor management. Even at this age, we ask some of our teens parents to take back some responsibility and some control over their kids diabetes management and try to make a "partnership" with their kids. And what that partnership is, is different in each family.
I am all for therapy as part of the treatment plan, but I definitely would not see that person again. That person sounds dangerous.
good luck.

I'm sorry, I'm T2, not a parent of a T1 and I certainly was not diagnosed as a teen. But I would like to make two suggestions. I know that you are focused on his testing and his A1c, but those are really symptoms of the larger problem. First, in 2011, I met a therapist in DC. Her name is Jody Brand Levine (http://diabetestherapyandmore.com) and she specializes in diabetes and the use of cognitive behavioral therapy (CBT). CBT is used to deal with anxiety, depression and problems with adhernce. While Jody is not in your area, she might have some good suggestions of colleagues in your area.

The second suggestion is that maybe it would help your son to have a "coach." You can't be a coach and you don't really understand what he is going through. And he may not always see you as being on his team. A coach might get through to him. I know that people like Ginger Vieira do this, she was diagnosed as a teen and might be able to get your son to work towards getting his head screwed on right. And while I didn't have T1 as a teen, I did have real problems getting my head in order. Once that happens, the testing and the A1c will fix themselves on their own. They are a symptom of what is wrong, they are not the problem.

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