# 16yr old son not doing enough checks



## Nicole49 (Feb 9, 2017)

hi, my son started the using the medtronic 640g pump in November 2016, he started off doing at least 4 checks a day but going by his reactions lately that as dropped to 1-2 checks a day, (won't let me do a download to see what's going on, although i will be tonight, no questions asked). i'm worried his diabetic team will take the pump away from him as although he is not doing the checks it has made a very positive effect on his overall daily levels and his recent clinic appointment was positive.
i have been looking at cgm's but really don't see how i can afford them for him, has anyone had any luck claiming PIP for a 16yr old who doesn't have complications, he knows when he is having a hypo and can do checks and admininister insulin when needed, he just needs constant reminding to do his checks.
i'm also considering his future as he is going to be attending college in September doin a motor mechanics course so i'm more worried that he will have difficulty getting blood glucose readings due to grease and dirt on fingers.


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## grovesy (Feb 9, 2017)

Welcome.


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## Ginny03 (Feb 9, 2017)

I get that you're worried, any parent would be - but I think you need to be careful about how you deal with this. 'I will be tonight, no questions asked.' ... if I were your son I would see that as a massive breach of trust. It wouldn't get me to increase the number of tests I was doing, it'd just mean that there was no possibility of me leaving my meter lying around again. He's 16, not 6 - you need to discuss this with him as an adult. You are going to get to the stage where there is nothing that you can do about his control - and that is terrifying - but you don't get a choice. Nagging will get you far further at this stage than alienating him by going behind his back - guilt trips always work well too! 

I think you're unlikely to be funded for a CGM, but it never hurts to ask. If you can manage the cost yourself, the freestyle libre is a great compromise - particularly for those of us who do hands on work!


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## Nicole49 (Feb 9, 2017)

Thanks for your comment, I understand that he needs to have his own control over his diabetes, but I have suggested to him we do a download just to see how things are not to nag and see if any adjustments need to be made as they haven't been looked at since the beginning of January at his last clinic appointment, but his reaction tells me that he isn't doing enough checks and he has a 3 month review for his pump in 2weeks time and I really don't want them to take the pump away from him as it has done him so much good. I just need to encourage the checks. I have been leaving him alone to take responsibility and just reminding every now and then, tried rewards, taking things away.
I know he won't get funding on the NHS for cgm. He was getting dla but then turned 16 and now has to apply for pip, just wondered if anyone had been successful with their application as this would then in turn pay for cgm.


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## Pumper_Sue (Feb 9, 2017)

A very simple and effective way is to tell him that unless he tests at least 4 times a day the pump team will take the pump away.
This is because he is not safe using the pump with only 2 tests a day.

Another sweetener is that at 16 he is probably starting to think about cars/mopeds etc., Perhaps hint that he would have problems getting a licence due to his non compliance.

It's very hard for teenagers though so try not to be to hard on him just point something out to him and let it sink in without you dwelling on the subject. The more parents nag (in child's eyes) the more stubborn they become.

Perhaps also give his dsn a ring and explain what is going on so s/he can have a chat with your son. Just ask that your call be kept confidential.

Another trick teenagers are fond of is forgetting their meter when due an appointment. So make sure you do have it when you leave the house.


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## trophywench (Feb 9, 2017)

Bet his phone's constantly within fingertip reach - any use suggesting he sets himself a pesky reminder at whatever times he needs to check?

(There must surely be a more modern equivalent of Ozzy Osborne giving the directions on TomTom - and having a rant at Sharon when 'she' went the wrong way? Or indeed Cupid Stunt or Prince Charles with your Ansafone or doorbell message, etc)


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## Redkite (Feb 10, 2017)

If it's just a question of forgetting, he could use an alarm on his watch or phone - this is what my 16yo does, and it works well in a normal school day with the structure of a school timetable.  Things are harder at weekends when there is no real routine or fixed mealtimes.  Ask him as a minimum to test his BG before each meal and before bed.  He won't forget to eat (unless he's a very unusual 16yo male!), so he needs to start associating eating with testing.  I assume he remembers to bolus insulin?  Frankly, I don't think clinics should threaten to remove the pump without first offering support and encouragement to help him turn things around.  Threats are no good for teenagers.  If he's using the linked meter, they'll be able to see the number of tests done from the pump's data.  If he uses a separate meter, I'd "forget" it so they can't look and criticise.  At the same time though, you do need to impress on him that he is risking DKA by not testing regularly (ie high levels due to pump/cannula problem would remain undetected until too late).


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## Smiric (Feb 12, 2017)

Try the freestyle libre - cheaper than the alternatives. Bought one myself recently and it's a hell of a lot better than blood testing all the time (used to do 10+ tests a day). .. wish it was free/at least reduced, but unfortunately the NHS is a system... and systems tend to be very slow and inept at changing/keeping up to date. Unfortunately, I've not found where to push yet. But I will.


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## Pumper_Sue (Feb 12, 2017)

Smiric said:


> Try the freestyle libre - cheaper than the alternatives. Bought one myself recently and it's a hell of a lot better than blood testing all the time (used to do 10+ tests a day). .. wish it was free/at least reduced, but unfortunately the NHS is a system... and systems tend to be very slow and inept at changing/keeping up to date. Unfortunately, I've not found where to push yet. But I will.


If the op has a pump that can be linked to a cgm then the libre isn't cheaper. Also it is well stated that you must not use CGM/libre for making clinical decisions which include corrects and bolus for meals.


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## Smiric (Feb 12, 2017)

Pumper_Sue said:


> If the op has a pump that can be linked to a cgm then the libre isn't cheaper. Also it is well stated that you must not use CGM/libre for making clinical decisions which include corrects and bolus for meals.


Ah kk, fair enough - not done enough research into it myself yet - what's cheaper for them? I don't test for corrects/meal boluses, but I'm not necessarily recommending other people to do that - just saying that it works for me - CGM has always been +/- 1mmol.


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## Pumper_Sue (Feb 12, 2017)

Smiric said:


> CGM has always been +/- 1mmol.


Libre isn't a CGM, and there's a 20 min time lag from a cgm reading compared to a finger poke.


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## Smiric (Feb 13, 2017)

Pumper_Sue said:


> Libre isn't a CGM, and there's a 20 min time lag from a cgm reading compared to a finger poke.


Yeah I need to get used to not calling it a CGM... just feels like one cause it provides a graph =P. & yeah there's a time lag.. doesn't seem significant though, just gotta be wary of it when you've done exercise, or something else which would rapidly lower/higher your blood sugar.


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## Pumper_Sue (Feb 13, 2017)

Smiric said:


> Yeah I need to get used to not calling it a CGM... just feels like one cause it provides a graph =P. & yeah there's a time lag.. doesn't seem significant though, just gotta be wary of it when you've done exercise, or something else which would rapidly lower/higher your blood sugar.


The time lag and accuracy of a CGM is a big factor when pumping, it's foolhardy to say the least to rely on a cgm reading.


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