Sugar lows

My son is 21years old and was diagnosed with T1D at 12years old. He is going to college and lives at home. He has the CGM 5 that alerts him when he is low, however, he has it set at 70 and on vibrate. Due to this, he has missed his low readings at times, and I have had to administer the glucagon and found him unconscious several times. It really takes its toll. I have tried several times to bring up the insulin pump, especially the one with the closed loop system. I feel it would be extremely beneficial to him and put me a little more at ease. He says he does not want 2 things attached to his body. He refuses to try it. I am trying to make him realize how serious these lows are, to no avail. Any suggestions on how to reach him about the pump as well as the seriousness of these lows. Unfortunately, he often does not remember what occurred. If I push too hard, he shuts down. It is all about control.

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@dsullivan, my reply will not be a popular one.

you can lead a horse to water, but you cannot make him drink.

you did a great job, now probably the hardest challenge you have as a parent is letting go. I am a parent as well, and even though this sounds criminally insane… you’re best strategy is to do nothing. You simply can’t be there for him 24x7. He will not have you around for the rest of his life either.

Believe me when I say that a severe low ruins your day. He knows. I can’t disagree with him either that all the tech hanging off your body is unattractive to a 21 year old man. It may sound like heaven on earth to you… but you don’t need to push metal under your skin everyday. . Also, the 670G is not the end-all answer to every parent’s dreams, because it has it’s challenges and issues… not the least of which are accuracy and .reliability.

When it comes time, and a technology decision is something he wants, then he’s likely to do it. I’m sorry I don’t have a direct solution for you.

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Hello D @dsullivan , all the tech gadgets available will not help your son unless and until he realizes that he must take care of himself - be his own primary carer. In the many years that he has been living with diabetes, he should know what he SHOULD be doing; it is probably time that you let him spread his wings and fly on his own.

To begin, he should set his Dexcom G5 alert and alarm notifications appropriately for him - I have mine set so that I can not ignore them.

But more basically, he needs to take a closer look at his insulin dosing [after this long with diabetes he should be able to adjust amounts on his own] such as carb ratios and insulin sensitivity factors. Calculating an appropriate dose of insulin is simple arithmetic and surprisingly accurate if one has a BGM or CGM. I did these calculations in my head for 47 years before I got my first pump and winged it for years before the advent of the BGM.
Good luck to you on letting go, but in the longer run you will be doing him a favor - he has to learn to take care of himself.

I don’t want a pump (yet) for the same reasons, but here is what seems to work for me:
I LOVE the alarms on my G6 because I don’t have to worry too much. My HIGH alarm is set for 190, but I often cancel at night because my sugar will tend to drift down before morning. My LOW alarm is set for 80. It gives me more time to catch it before I have symptoms. I have a juice box and granola bar at my bedside. If the LOW alarm goes off (1st one is vibrate only), I’ll eat, drink whatever and go back to bed WITHOUT cancelling the alarm. Once my BG is back above 80, the alarms will stop and I can usually get through the rest of the night.
It’s fairly simple. But I’m 58, not 21. I can’t presume to know what his motivation is for not using the alarms. I hope he can figure that out. But as the others have said, he’s an adult and you have done all you can.

Maybe I should have said that the alarms allow me to be more PROactive (popular business buzzword) instead of “worry”. I live alone and would prefer not to have to have anyone (friend, family, mailman) find me dead in the following week.
I HATE this disease. Don’t want it. Don’t deserve it. But I have to deal with it (as he does).
I would suggest that he is not being fair to YOU. My 2 cents.

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My question to him would be why have a CGM attached at all if you aren’t gonna take advantage of it. Whose idea was it to wear a CGM?

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I too have the G5, u set low alarm for 80. It gives me an extra 15-20 min to respond. It’s a good thing too. I never worry about highs cause I drop down within a very short time frame.

I think I understand what he’s thinking. He’s 21, all boy, not yet man(mentally). He wants to be “bulletproof”, like all the other guys. Nothing to stop him or make him any different, it’s all about the girls and what they might think. I call it the rudolf syndrome. Hiding the nose, so to speak.

Unfortunately,this nose can kill him! He will understand soon, but getting past this, it’s gonna be a journey! Some boys are harder headed than others. I don’t know your son, but maybe a frank, honest conversation with you, dr, dad etc… kinda intervention thing. That might help open his eyes to the fact that there are women out there that won’t mind if he’s different. I’m just guessing, but sounds / feels like I’m close. Only he knows for sure! Hope I’ve helped.

My daughter is 8 and she was diagnosed with type 1 2 years ago. For the first year and a half we did injections by the pen. I was very hesitant to try out the pump but I took a class at her endocrinologist about all the different types of pumps and monitors. Although you can only make suggestions, my daughter has the g6 and she does not have to check her blood nearly as often. She may poke her finger only once in ten days which is how long the sensors last. She also had the Omnipod pump which has no tubing. Maybe you could show him the variety of pumps and monitors out there. Good luck! Hopefully he will change his mind for a piece of mind for yourself as wel!

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Hello dsullivan! I read about your situation with your son. I can completely understand! I’ve been in a similar situation for almost 50 years. However, I’ve only been on a pump for two years and a cgm for one year. I was always going low. I thought it’d be fabulous to know about them; so, I could take action to correct them. I had a really good diabetic educator and my endo now for about a year. They suggested I raise my alarms to 85. This way I’m still mostly aware when I’m woken up by an alarm at night due to my sugar starting to go low, and I can deal with it. Not sure if he’d be open to doing this, but it’s an excellent idea for helping to control low sugars! It sure has worked wonders for me! It’s also more proactive on his part. Let me know if any wonders come up for you or him around this idea. Take care, good luck, blessings, Dave

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Thank you for suggestion. I will definitely mention to him.

You definitely have. Thank you for the insight.

Thank you for your input. I truly appreciate.

I totally agree. The bottom line is it is totally up to him. It is his disease and he needs to contend with it. Just hard, especially when see lows.

@mbd2319 ?Marybeth, we love the Dexcom g6 for our daughter and are looking at pumps now. I like the freedom of the omnipod over the t-slim, but wish it would loop with the Dexcom. How have you found having the two? Has it been ok not to have the added feature of turning off the insulin when numbers are going down? Thanks for your input!

It isn’t bad at all with the two! Since she has the g6 it does alert her when her blood is low and it tells us if we don’t treat how much it will go down in how long. I don’t find it difficult for the two and being able to turn off insulin delivery. I let my daughter decide in the end which pump she wanted and the Omnipod really is great for her. She doesn’t have to worry about getting it wet when she takes a shower or goes swimming. The g6 is small enough where it doesn’t bother her to have it on. I do wish that with a no tubing system she would be able to monitor her levels and give insulin so she would only have to wear one device but they are small enough to keep under her clothing. these two systems have been working out great for her!!

Hi Marybeth @mbd2319, I too would like to have only one thing [talking CGM and Pump] rather than two constantly attached to me.
At the present time, with the devices generally in use, if you want continuous BGL readings and insulin infusion two sights, separated by three inches, are required. The only exception to the user needing to place both an insulin infusion and a CGM sensor is the Eversense CGM by Senseonics which was approved for use by the FDA last summer.
The Eversense sensor is placed under the skin by a trained physician every ninety [90] days; a 180 day version, currently in use in Europe, is awaiting approval for use in the USA. At a presentation I attended this week, I failed to ask how closely insulin can be infused/injected.
I don’t have current information on an infusion set being developed by Medtronic that included both an insulin canula and glucose sensor.

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I’m not sure about the G5 but it should be similar to the G6. My daughter has the G6 and up to 5 people can follow her and her sugar. It is great because if she goes low or high we all get an alert and everyone can set their own alarms/alerts. Sometimes my husband and I will miss my daughter low reading but then my parents will text/call us to check on her. It’s great because we sometimes miss the alerts or we are sleeping. I know your son is older and may not want many people following him but maybe only you can follow him so when he is low you can call or text him to make sure he is ok.
At first I was against pumps because I didn’t want a lot of things attached to her little body especially having tubes so I didn’t push for her to get a pump and every time I showed my daughter pump pictures she didn’t like them either. But recently my insurance approved the omnipod and I got excited because it’s tubeless. My daughter was not sold on it so I got a demo box from the company n put a pod on for a day to see if she would like it and she did! My daughter liked it and can’t wait to get it next week so can eat all day. Maybe u can contact omnipod and they can send you a demo box so he can see how it feels and looks. It’s not a closed loop system yet but they are working on it. Omnipod also said in about 2 years you will be able to control your pump with your phone. I can’t for that to happen.

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@mbd2319 Marybeth, great to hear about your experience. I love that you had your daughter decide which pump to get.

This sounds like me at 21. I did not take care of myself at all during college. He will feel like absolute crap. One day he will wake up and not want to feel like it anymore and won’t do it to appease his mom or his doctor but rather himself. Took me till 23 to really get a hold of it and I was diabetic since I was 4. I am on the closed loop as well so if your son wants to reach out don’t hesitate. Diabetes blows and having someone tell you to take care of yourself is the worst.

Maybe your son doesn’t know that there is a lag time between blood sugar and the G5. A Dexcom educator explained this as “the cgm shows “where your blood sugar has been.” I set mine to alarm at 85 so that I have time to treat a low when I am going lower -before a low actually occurs. I have had very few true lows for over a year because I can prevent their occurrence.
I have had diabetes for 55 years and still take shots…I too do not want to have anything else attached. But the cgm has been a godsend.
Maybe your son would agree to try having his cgm alarm set at 85 for just one week to see if that helps him feel more in control of his life.