Forgetting to Bolus

My daughter is 7 years old and can bolus using her pump (she was diagnosed at 3 and has been on a pump since she was 4). We tell her what carb count to enter, she tells us the amount of insulin recommended and then we say yes or no based on whether it sounds reasonable. This has been our process for about a year and had been working fine, until recently. There have been several times lately that I have caught her not following through with the bolus after we have verified the amount (the pump makes a noise that will alert me). We had a really bad night last night. At dinner I told her to bolus and I did not catch that she hadn’t and the same thing happaned with my husband at snack time. This resulted in staying up most of the night to get the blood sugar back down to normal. Things are really crazy in our house right now with schedules and such; but I was mortified that we not only missed this once, but twice (IN A ROW)!!!

I am trying to get my daughter to take more responsibility with her diabetes (remembering to test, testing herself and bolusing herself). The problem is, she does these things only when she is forced to do them, never independently. I really do not get the feeling that she is doing it on purpose; she is easily distracted and relies on us to remind her to do almost everything.

Am I asking too much from her at 7 years old? Do any of you have suggestions on what I should do to make sure nothing is forgotten? Any help would be greatly appreciated!

I have a 13 year old that forgets sometimes too and because of it she has had to miss a test at school because she is too high based on her 504 plan. I think it is great that you are working to make your 7 year old independent but remember she is only 7 and she has a lot of responsibility to take on at such a young age. I’m still trying to practice this grace myself with my 13 year old. I usually wait to see her do her bolus on the pump before I let it out of my mind. It has been those times that she is rushing out of the door for the bus that she forgets to bolus and I am not there to make sure she does it. Remember we parents are human too so don’t beat yourself up about missing it twice; you’re doing a great job.

Hi Aimee,
just for comparison purposes our little one is just turned 11 and on MDI since dx a year ago. She does her own pen injections but we work out the doses (she’s quite unstable). However, we do check to make sure she is doing it and find it useful to have her repeat back to us the number of units she’s going to take before we leave her to get on with it.
I think having her repeat the instruction helps cement it in her own mind a little better. 7 is probably a little young to expect her to remember things - even for a few minutes! But I too know how hectic house-life can get - mistakes are always going to happen…
All the best, J

My 10 year old has been doing this as well for quite some time now. He was also diagnosed at 3. Since it is such a regular routine, I too thought he should be able to remember. Well, I’ve had to take over his diabetes care again after a 9.9 A1C. I made a diabetes log and attached it to a clipboard. It has the times he needs to test with room in between to write down his snacks and food amounts. I set alarms in his cell phone for the times to test and I follow up to see that he’s done it. In addition, I stand next to him while he boluses himself. He is easily distracted as well so I had to figure out something that he could work for to earn something at the end of the week if he keeps his chart filled out and remembers to bolus. If I’m not in the room at the time he should bolus, I look back in history within a reasonable period of time to make sure he’s bolused. I think he’s just totally burned out with diabetes and the doctor suggested that I take charge again. I’m trying to establish a new routine of having him right things down on the chart and put a check mark in a column next to it if he’s bolused. I totally understand how busy it gets and things get crazy. It’s very difficult when you’re in a rush. You’re doing a great job…it’s figuring out how to make it a positive thing, at least in my case, where he can work towards something he likes. Good luck and hang in there :smiley:

Our teen was diagnosed at 8. We did not allow unsupervised boluses for at least a few years. She went to the school nurse before lunch at school. If on a play date she would call us and then she would bolus after verifying she was giving the appropriate amount. We would often ask her to go into bolus history and repeat to us the amount of insulin given if she was giving insulin unsupervised. We were not worried about her forgetting to bolus; rather, that she would accidentally put in the wrong amount. Bolus history was used for her safety. Status 2 on the Animas pump; now with revel IOB is right on the home screen.