New to Type 1, and Two Homes?

My 16yo son, newly diagnosed on August 26th, 2012, is struggling. His father and I are divorced, have been for 14+ years. And Dad is remarried, so already tension in the house.
I am not sure he is getting the support at dad's with his counting. He describes it as, they just leave the cans/boxes from dinner on the counter for him to "figure it out".
I know I need to take some of what he says with a grain of salt.
But how do I not overstep my bounds and help things out at dads???

Mom of T1

I'm not sure I can comment about dealing with how to not overstep your bounds when your son is at his dads, that sounds like a tricky situation. Speaking from experience as a former teenager with Type 1 though (I'm 30 now but was diagnosed at age 11), it seems like the best thing you can do for your son is to empower him with the knowledge he needs to take care of his own diabetes needs. Chances are, now that he's 16, he's going to be in lots of places other than just his dad's house where he won't have help counting carbs and dialing up his shots (like at school, at parties, out with friends, etc.) so he needs to know how to do it all as best he can on his own anyways. It takes time to learn the ins and outs of taking care of your own diabetes, but I think at age 16 he is more than ready to start doing this on his own. If he needs help figuring out how to count carbs, work with him when he's with you so he can do it with out help, and then he'll be able to do it on his own whereever he goes (including his dad's).

I too was dxed at 16 but many years ago before there was all the education that is avabile today. I agree with Erin, your son has to know that the ball is in his park and he can depend on you when needed but there will be times when he has to be responsible for HIS DIABETES. I know it's hard to step back, you can be his support but you can't do it for make all information available to him and let him know you're his support but you can't do it for him.

No need to cause any tension. Buy two copies of the books "Type 1 Diabetes" by Hanas and "Pumping Insulin" or "Using Insulin" by Walsh. Give one copy to him, and read the other copy yourself. Start a book club with him to talk about what you're reading, and discuss with him as you both learn about the disease.

If you think your former husband would read them, buy him a copy too.

These are both great books: the Hanas book is geared towards talking to a young adult with T1 diabetes so he should be comfortable reading it. The Walsh books are also excellent to understand how to tune his management, though he is so newly diagnosed that tuning may be especially hard. I wish these books had been available back when I was diagnosed (back in the days of one injection a day of NPH and no blood glucose testing).

I've gotten more out of these books than I've gotten from all my appointments with Endo and Diabetes educators over the 37 years I've had T1.

Thank you! Will be checking Amazon tonight!

A couple of other book recommendations , if he will read them.

"Think Like a Pancreas" and "The Ultimate Guide to Accurate Carb Counting", both Gary Scheiner . I have them on my smart phone too for quick lookups, along with the GoMeals app (essentially, the CalorieKing book) to look up things at restaurants, etc. It also has all the fast food places.

I agree with the comments his age he will be out often with friends, eating out, etc and he cannot rely on you to do his management for him.

There are lots of simple approximations that will get him close....he needs to learn,
for example, that a closed fist size pile of mashed potatoes or rice is about a cup and this is about 30g of carb, etc. With learning a few approximations for common food like this, you can be shown a plate of food and quickly make some estimates. Yes, it wont be as good as weighing it out on a food scale or looking at a package, but many times it will be good enough. Even with labels and weighing there are lots of errors.

The books above will teach him these approximation techniques and/or he can take a class. Then he will be free to go wherever and have the confidence he can manage things.

I was shocked to see a grown teenager at my diabetes center who still had his parents giving him dependent that must make him feel!

Just my opinion as a long-time T1, BUT, at 16, he should be able to do his own carb counting. I've known kids who are much younger who do a large amount of carb counting themselves. If he's old enough to be driving a car AND assuming that he doesn't have any developmental issues or learning disabilities, he really SHOULD be doing most of his car independently. In just 2 years, he will be able to move out of the house. He may already be driving or starting to drive; when you do that, you are away from home more and need to be even more responsible for your diabetes care. BG management is suddenly MUCH more important.

Also, at 16, he's probably hanging out with friends more. This can lead to lots of tricky food situations. He is going to need to learn how to navigate those food situations on his own, without his parents present.

How much of his carb counting are you doing when he's at your place? Is he administering his own insulin and figuring out the dosage? What other aspects of his care are you doing that he really has the capability of doing?

Some other things: If he's not already doing this, he should also be responsible for getting his prescriptions filled and scheduling doctor's appointments. He needs to start learning how to navigate that very important aspect of his care. He needs to learn how to deal with the pharmacy and all the issues that come with that. I know this sounds like a lot, but my parents did this and I was SO grateful than when I turned 18, I knew how to do all these things and was able to confidently move out on my own. Yes, kids with T1 have to grow up faster, but it just makes us smarter and more competent in the end.

What a challenge he has! But teens meet and figure out challenges. I guess you might leave the cans/boxes from your meals on the counter and play "Figure it out" with both of you doing it, meeting the questions along the way. And he'll get good at it! He's got to be put in charge.
My daughter made some pumpkin bread for my husband and me this week. She cut out the nutritional tag and stuck it in with the bread! I thought that was really nice! So my inclination is to say "How nice of them to put out the nutritional information for you. Perfect!"

I agree with MyBustedPancreas about the learning to navigate the healthcare system (prescriptions, scheduling dr.'s visits, learning how to read bills and explanation of benefits from health insurance companies) on his own too. Unlike MyBustedPancreas my parents did NOT teach me about this stuff and I spent several years really hurting as a young adult trying to figure this stuff out on my own.

I was diagnosed T1 at 14 so think I know where I'm coming from.

Some teenagers might need a lot of handholding through all the minutae of nutrition/insulin/etc. but providing support at a higher less detailed level is probably more appropriate.

i.e. make sure that your son gets the education and supplies and resources and let him do the mechanics himself.

Jag - was just checking out the Type 1 Diabetes book on line, the cover looks very childlike. Is that then the right book? Just want to be sure.

Hello Amy:

How old is your son now?

In point of fact, different approaches might not be a horrible thing. We all in time have to figure things out, adult or teens. Is that a cup or three cups? What might be lacking assuming the description of events is accurate (???) becomes the human challenge factor?

How much do you think that was kiddo? Youre right, I measured it... or the opposite nope, not even close... A really grown up, if hands off approach.

Tell how good he's measuring the amount at dads retesting 2 hrs. after eating X. If he gets it right, his numbers will be in a decent range. Guessing wrong, the number will be higher...

He'll have to figure it out someday without being nudged/watched why not start him off now. No foul...


He needs to learn to control his Type 1 by himself. I do not mean to sound harsh, but the best thing YOU can do for him is to teach him to take control of his Type 1. He is 16, and old enough to work out the situations. If "they just leave the cans/boxes from dinner on the counter for him to "figure it out,"" teach him how to do that. It will be the best gift you can give him. Unfortunately, his control is not up to you or his dad. It is up to him and you need to teach him how.

Read the books, but better yet, get him to read them and then discuss.

I know, when it comes to Xs most of us prefer to keep our distance, but its been 14 yrs and it wouldn't be overstepping to call your X and suggest having an informal get-together including You, your X, your Son and if you can stand it your Xs new wife. Having her there would make her feel better about the get-together and would therefor prevent the tension that comes with jealousy. ALSO, write down a list of topics to discuss and think about ways to talk that wont put others on the defense. Friendship is much more fun and productive than it's alternative. I saw my X a Few months back at the hospital where my son's wife was giving birth and it was probably the first truly pleasant conversation that I've had with her in almost two decades. It takes a long time but eventually we grow up.