Hi everyone,
I really need advice from parents of T1 teens. We’re the parents of a 17 year old T1, diagnosed at age 10. The three of us have worked together pretty well to manage his BS. Before he even was old enough to get his driving permit, we stressed how very important it is that he checks/manages his BS about an hour before he gets in the car so he can adjust his basal, take a correction, have a juice. That if he’s out of range, he won’t be allowed to drive, because he can put himself and others on the road at risk. His management as he started driving has been OK, but he has recently started being reactive instead of proactive on when he’s low or high. He’s procrastinating until last minute when he decides to check his BS before driving, playing the victim when we tell him he can’t take the car because he’s too low, etc. Have you been through this? How have you handled it?
Hi @natrock1 . I was diagnosed at age 3, so by the time I got my driver’s license I was familiar with what insulin reactions (as we called them back then) felt like; and although mine weren’t very serious (meaning I could usually pull myself out on my own), I appreciated that driving while low was not safe for me or anybody else - including my doctor, who had to/has to sign off that in his professional opinion I can safely operate a vehicle that weighs a couple of tons and can do tremendous harm.
Sometimes Mom or Dad’s opinions don’t matter as much as someone else’s, and a reminder that his endo is vouching for him might sway him. As I was approaching driving age my doctor discussed the inportance of having a snack or meal before getting behind the wheel, and to not even think about driving if I felt the least bit funny (no BG meters much less CGMs back then so we went on how we felt). Since your son is giving you trouble in this regard you could see if his endo would be willing to call between visits to see how things are going and remind him that he needs to remain responsible to keep his medical clearance.
Positioning the maturity of putting safety needs ahead of his own desires might be appealing.
And give him a reminder of the consequences if he should have an accident due to his glucose. In addition to whatever damage/harm is done to the vehicle and/or people, his doctor might pull his approval and he could lose his license. Your insurance rates would increase, and you could hold him responible for his own coverage or at the very least the difference in premiums.
And he may feel guilt over the damage that was done as well; and regret and stupidity over how simple it would have been to make sure he was really ready to drive in the first place.
Some of us may have diabetes that is hard to manage even with the best existing loop systems available. But for many or hopefully most of us, those tools are sufficient to keep us and others safe if we are willing to use them responsibly and do what we need to do.
As my mother was getting older I reminded myself the day might come when I would have to call her doctor or the DMV about pulling her driving privileges. Thankfully it never came to that: she voluntarily took herself off the road when she started losing her confidence, but the choice was her own - which we all hope for.
WOW, your answer is very well thought out and detailed. I greatly appreciate that; it feels like a hug of reassurance. I want to give him more freedom and autonomy, he thinks I’m being restrictive. I love your ideas and approach. Thank you.
My pleasure to help. I hope you find a way to get through to him, whether with these ideas or others. Keep us posted!
Natalie @natrock1, the real criteria in my opinion is Maturity, Responsibility, Awareness. Without all three, driving shouldn’t be considered and his “playing victim” gives me concern. I may sound harsh, but a tom of metal and plastic is considered a deadly weapon in courts.
As far as checking BG before driving and periodically on a drive, when necessary, SHOULD BE for him an automatic Responsibility reaction. When I got my motor vehicle operator license in 1957, digital BG meters were not even a dream - BS test in a hospital took more than a day to develop.
It is a good practice to always check BG before driving (my ashtray always has used BG check-strips in it even though I use a CGM), but safety is important. Explain to him that he must always be Aware of how he is feeling and leave the road if he feels low or isn’t sure - check BG and snack when necessary. As far as “lowering baal rate” tells me that his pump settings may need adjustment.
I, too, am one of those diabetics who started driving years before the cgm and pumps. I didn’t start using a glucose monitor until I was already driving for 6 yrs. Diabetics are so fortunate to have cgm’s and glucose monitors to make driving, and life, better now. I think testing right before driving is good and is what I do when I don’t trust the cgm or don’t feel right. Your BG an hour earlier can be so much different than an hour later. I’ve never had a wreck, but I have sat in many parking lots for 10 or 15 minutes before driving. My recommendation is that you or he make sure there is always a bottle of glucose tabs in the glove compartment ready for when it is needed. Knowing it is there will provide you some relief. Granola bars or gummies, etc. could be there too, but his friends won’t want to eat his glucose tabs. If he can’t drive the car for 15 minutes while he waits for his BG to rise, he might start testing a little earlier so he won’t be late. Your son is a teenager and probably more responsible and disciplined than most teenagers because of having diabetes. The best to both of you!
@mkenni Thank you Mary for sharing this wisdom, we look forward to seeing you here, often. And, Welcome to the JDRF TypeOneNation Community Forum!
@natrock1 , just 1 addition to the excellent advice (glucose) from @mkenni ; I recall a debate about glucose vs. juice some years ago. I noticed that 1) my own rebound seemed faster with juice/soda, 2) drinking something (H²O/diet soda) seemed to speed the effectiveness of candy/donut/whatever-is-on-hand, and 3) the liquid volume seems to help me avoid over-treating the ravenous panic-lows (Usually. Sometimes.)
If your teen finds similar results with his lows, perhaps bottled water + glucose? Maybe a 20oz sports drink? (The sodium + other electrolytes may even prevent it from freezing in SOME winter months, depending on how far you live from glaciers and ski hills…)
My most miserable low-while-driving was Feb. 1987, 6000ft elevation, <40mg/dl, freezing my tail off with the heater running full-blast in the parking lot of a 7-Eleven while I INHALED the biggest Slurpee they sell. I still can’t say if my shakes were hypothermia, hypogycæmia, or brain-freeze. (Funny how the low-brain “thinks”; I was ravenous, yet nothing in the store sounded good EXCEPT a Slurpee. In February.)
I thank God Almighty for every low my CGM helps me avoid. A finger-stick back in '87 may show a perfect NUMBER, but without a direction indicator, that glucose doesn’t last 2 junctions, or even a motorway merge!