Daughter in College - Not managing well

(Milaka) #1

Our daughter (dx 12/19/17) is away at college in another state. She is NOT managing her T1 well. Her A1C was 9.8 at this week’s appointment and she’s not alarmed at all. My husband spoke with her doctor yesterday (thank God she signed the papers to give us access) and he said that she admitted that she’s not covering for snacks - which she did not tell him at her LAST appointment in February. Because she didn’t tell him that, her basal was too high and she goes low every night. He adjusted her basal yesterday, but that’s going to exacerbate the highs if she continues to eat and not bolus. (No pump yet - too expensive - so she’s on MDI.)

I spoke with her today - not telling her that we talked to the doctor - and she misrepresented the appointment. She said that the doctor wasn’t worried and told her that her A1C would get better after she got back on the Dexcom. (Our insurance changed their coverage of the Dexcom and we’re in limbo.) She also told me that 9.8 wasn’t bad and that I needed to stop looking at the internet. I’m sure that a lot of her attitude is related to being so high for so long, but it is still very frustrating.

I’m looking for some tips on how to support her in her health without nagging. Is 9.8 really no big deal? (She told me I was being a perfectionist for wanting it in the lower 7% range.) What battles should we fight and which ones should we let go? Any help at all is appreciated!

Ironically, her major is Nutrition and Dietetics and she said she’s interested in becoming a CDE. Sigh.

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(Dennis J. Dacey, pwD) #2

Hi Milaka @Mintlaka, first let me offer you a Warm Welcome to TypeOneNation Forum! I expect many folks here who are more conversant with 20 year old girls will offer you grand suggestions and advice. Second, your daughter sounds “normal” for her age and circumstances of being away at college. Fifty years ago my disregard for my diabetes care knocked me out of college; I smartened up a few years later and returned to the chore of getting my degree, with honors, going nights while working and raising a family.

You didn’t mention how long your daughter has been living with diabetes, but at her age if she has had TypeOne for more than just two or three years, she should really know how to adjust her own insulin; I know, some doctors, even good endocrinologists, will not let go and insist that patients become comfortable with diabetes management “fine points”.
MDI is really great and especially with a BGM [Blood Glucose Meter] she could do real good. She must be VERY careful not to stack insulin and cause herself to go low; almost never should she take a correction dose of insulin within four [4] hours of a mealtime dose. I would rather see her average BG a little bit on the high side rather than seeing her suffering from too many hypoglycemic events. Like you, I think HbA1c of 9.8% is a little too high.

As for what will “change” her so that she will manage her diabetes better is something different for everyone. Many of the people here who have lived with diabetes for over 60 years, like me, will tell you that they went through a considerable period of time where diabetes care was neglected or forgotten. I went several years without seeing a doctor and that meant not getting a “blood sugar” lab test that had to be done at a hospital. Yes, I’m paying now for “neglect” and I’ll tell that to your daughter.

Maybe suggest that your daughter join this forum - there are many college age members here who will happily talk with her and share how they are surviving.

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(Joe) #3

I’ve lived though this and trying to force it just shut me down more, punishing or being “mom” about it just alway got annoying and was ultimately ignored. Support her the best you can as she’s an adult and is in charge of her health, it’s hard to be 100% all the time when it comes to your diabetes, it’s almost like your pissed because you have it so you say screw it im not gonna bother with it or wanting to ignore you have it. Obviously testing her limits with herself. I’ve been there. One high A1c isn’t the end of the world. I was in the 12s for the first few years you learn the tricks and hacks along the way. Suggest to at least take some kind of insulin when eating even if it doesn’t bing it down to normal it’s still will help keep it down some what.

Drinking makes it hard as well(I mean I can only assume that there occasional drink is consumed at college, Dexcom would definitely help with this especially) Good luck. It sounds like a rough patch at the moment but she will come around.

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(Milaka) #4

Thank you SO much for the reply. I forgot to say that she was dx her senior year of high school over Christmas break. We got diabetes for Christmas! She had a very long “honeymoon” period and the full force of it all hit her at the beginning of her first semester of college. Sigh.

She has used a Dexcom in the past. It was up for renewal and our insurance switched the classification and now it’s not covered under our pharmacy plan, but as “durable medical equipment”. So now we have to jump through all sorts of hoops to get the darned thing. She’s been without it for about 3 weeks now so that’s why the 9.8 A1C was so surprising. She’s been telling us that she’s doing well! Sigh again.

I’m feeling less panicked today than I did yesterday. I’ve talked with the nurse in her endo’s office, I’ve talked with one of her close friends on campus, I’ve talked with my husband (he’s on a business trip), I’ve prayed and I’ve slept! We’ll get through this. She’s a smart young woman and I think that she’ll come around quickly.

I am so glad I found this forum!

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(Milaka) #5

Thank you for your reply. It helps to hear the perspective of someone closer to her age.

I’ve tried to take the approach of being a coach - how can I support you? How can we handle this together? When she has her Dexcom on, I try to really applaud the good days and on the days when she’s not in range, just say “Okay, that’s over. How can we do better tomorrow?” It’s just hard when I can see that she’s 22 out of 24 hours in the 200-300 range.

We do have an agreement that I can only text once a day asking about her numbers. As in - only one nag per day. (All bets are off if she goes low, of course. Then I text or call until I get her.)

All this to say, her dad and I are learning too. We’re trying not to freak out and we’re trying to be supportive. It’s a fine line! We’re also learning how to have an adult child - she’s our oldest!

She’s a great young woman. She’ll come around. It’s just hard to see her putting herself through this when she doesn’t have to.

I’m going to encourage her to jump on here. (Of course, she may resist because I asked.) She does have a good support group at college - her roommate follows her on her Dexcom and prompts her to take care of herself, her big sister in her sorority is also T1 and is sharing the burden, and one of her best friends on her floor has a mom that is T1 so she (the girl) goes to her endo appointments with her and remembers to ask questions. I could not be happier with her friends!

Thank you again for your reply! I really appreciate it!

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(joe) #6

this… more than anything else, predicts a good outcome. Very glad to hear this part.

Your daughter is so newly diagnosed, please realize that grieving the loss of good health is a process and it will come very slowly. I know it seems scary to you, and that her control is “less than optimal” but with the support she has and the contact with others… means she is less likely to fall into a denial or depression that could take years to unravel.

it took me years to figure this out. and after 40 years with t1, control is never perfect.

got my fingers crossed for you both!

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(Joe) #7

You welcome, I know it’s a hard thing to go through and I’m sure she isn’t having the perfect time either. Having that support from friends is just amazing, when your away from home, you count on your friend to have your back, they are as good as family. Its good to hear they are trying to get her on track

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