Student I teach

[Bonnie23]

Hi

I have a student who is around 15 years old. He is T1 and has a pump.

I'm concerned with his habits. He doesn't eat well rounded meals and often wanders around with big bars of chocolate and lots of sugary drinks, I understand if he gets a low BG he needs these but when I've asked to check his levels they are often too high and he doesn't need the sugar.

I'm really worried for him, the nurse is involved and parents. What other advice can I give him? If he keeps going like this what would happen to him?

Thank
B x

 

[Jodee]

I think a referral to his diabetic clinic would be in order it will be up to them to instruct the student and his parents, in turn the parents should instruct his tutors. Of course he may be fully aware of the consequences and disregarding them. As his tutor you could just communicate your concerns and the dangers when the blood G goes too high and the causes to the student, to the parents, to the appropriate people, your seniors any medical person at college / school etc.

https://www.diabetes.org.uk/guide-to-diabetes/complications

If his blood glucose is consistently reaching 10+ mmol his vision is going to start to be affected, ie he will get blurred vision and unable to read properly the printed word, computer screens etc.

 

[Kaylz]

When you say they are often too high, what are they?

Type 1 is very different to Type 2 and as he's on a pump there isn't really anything to stop him having a bar of chocolate like everyone else his age as long as he's using the pump to deliver the insulin to cover the carbohydrates in it

I find it quite isolating at 28 so can only imagine how difficult it can be for a 15 year old lad being like the odd one out, his levels will also be harder to control at that age due to hormones, the fact he's still growing etc
xx

 

[Bronco Billy]

Hi Bonnie. First of all, hats off to you for caring so much. Teachers are busy people with a lot of pupils to consider, so it’s great to see you taking such a close interest.

It would be helpful to know what his high numbers roughly are. A bar of chocolate wouldn’t be used normally to treat a low blood glucose level as it wouldn’t act quickly enough. It may be used if he is on injections to sustain normal levels after glucose has corrected a low, but your description of it as ‘big’ is concerning.

Is he having school meals or packed lunches?

I wonder if it is a listening ear he needs rather than advice. I don’t know how long he has had type 1, but chances are he knows about diet. He may benefit from talking to someone he trusts. It might be worth asking the nurse if referral to psychology services has been considered.

 

[Lizzzie]

Hello! For a T1 there is no reason at all not to eat chocolate, even if using pens to inject. A low-carb diet is not needed (we have the technology). I am T1; I eat big bars of chocolate sometimes; I'm sure they're not good for me in lots of ways, but my BG rarely goes too high. It sounds to me as if you need to know a little about his blood sugars; what his own expectations for his levels are; ideally what is doctor's expectations are (although it is private, he might divulge if he senses you are not judging him). It also sounds as though there is space for you to ask what support he wants - and make it clear where you are if he needs more, or even needs to vent because it's mega frustrating and hormones muck your levels up at that age without you necessarily getting anything wrong. Diabetics are always being 'told' what's good or bad for us; what we should do or shouldn't do. I would always tell you to leave that to the medical professionals and encourage him to tell you about his diabetes, instead.

 

[SB2015]

Great that you are interested in supporting this student. It would be good for him to know that he has a person who he can trust to listen to him. Perhaps ask if there are any ways in which you can help him.

My first thoughts are about the forthcoming external exams. A student with T1 needs to be able to able to take a time out to treat a hypo, or a hyper if necessary, and remembering that we are not allowed to drive for 45 minutes after a hypo, I always encouraged them to take the time that they need to before returning to the exam. They should not feel rushed. This is often done my them taking their exam in a separate room, under special arrangements. This should not be the same room as those requiring a scribe (too noisy). Well worth talking to him about this, although I know many students just don’t want to be seen as different.

As others have said it is fine for him to eat anything he likes so long as he matches the carbs with insulin. I know that there are times my levels spike after a meal, and this may well be the case after lunch. So a high then will be no surprise and it is important not to double Bolus for the carbs.

Hope this helps