T1 D Sister Needs Advice

My younger brother has been living Type 1 Diabetes for the past 10 years and Addison’s Disease for the past 5 as a comorbidity. Considering the great psychological toll both diseases have taken on him, it no surprise to me that he tends to neglect his health and not care for himself in ways that are best for him. One consequence of this has been frequent episodes of hypoglycemia. Prior to my brother and I attending college at the same time (and we both attend the same school) my parents took care of the hypoglycemia incidents at home and the only task I had to do was go fetch some juice or Gatorade. I never had to work with my brother directly.

Last school year when my brother and I were both at college together there was one low blood sugar incident that was particularly traumatizing for me, as I found him (after my parents had requested me to go check on him due to being unable to reach him all day) when he was very very low (I think his BG was 17) and I ended up having to call for paramedics and taking him (along with the help of my brother’s friends) to the hospital… this was no easy task. Trying to reason with my brother when he is low is challenging due to cognitive decline and combative behavior (i.e. swearing, hitting, yelling).

I am incredibly anxious about another incident like this happening again as we both head back to college (living off-campus and working on our classes remotely). I am wondering if anyone has any suggestions on how to: A) deal with this very specific anxiety and B) prepare for this to happen again- what types of supplies should I have on hand in case of an emergency like this besides a glucagon? How can I prepare myself mentally if I encounter this again?

Thank you to anyone who takes the time to read and/or reply to my lengthy post. I hope you have a wonderful day.

Bless you for being such a good and dedicated sister. Two thoughts come to mind: first, does he use a CGM? It can be very reassuring for us with diabetes,and family members or loved ones. I can’t speak for the others but Dexcom’s has a feature that allows the user to share their numbers, and call or respond personally if they need assistance - whether you’re taking a nap or out grocery shopping you can see where his numbers are and if they are falling - or rising. Many transmit to a user’s handheld receiver (Dexcom’s is compact and fits easily in a pocket) or cell phone is he does not use an insulin pump.
Second, there is now an inhaled form of Glucagon which may be easier to administer than injections.
I wish you the best and hope your brother is willing to open up about his diabetes to a few trusted people friends in addition to you. You might see about meeting with a diabetes nurse educator to learn about diabetes if you’ve never taken one. And there is a book titled Think Like A Pancreas emphasized text that is very helpful. I know you’re getting ready to hit the books yourself but I think you’ll find it helpful to read our at least start beforehand.
Of course the key is to stay in control to minimize these events - which of course you know. Despite the multiple challenges he has - and perhaps even more important, because of them, he could benefit from counseling, from someone versed ideally in both conditions. If he tried before and didn’t connect I hope he will try again - sometimes making that connection with the right counselor makes all the difference - for the person and the family.
Wishing you the very best. Please stay in touch.

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Hi Dorie,

Thank you so much for your kind words and very helpful response. I really appreciate it.
To answer your question, my brother does not use a CGM. He used to use a CGM and there were some challenges getting it to stick on his arm. This angered my brother (which I can understand where all that anger came from) so because of the anger my parents just decided to stop using it. He could always try again though… and depending on how things go here this fall I may push for the CGM again.
It is good to know about the inhaled form of Glucagon. It turns out the Glucagon I have is old (expired March 2020), so replacing that with an inhaled form would definitely be a smart choice.
I appreciate the book recommendation- I’m always down to read and with my school utilizing a quarter system classes don’t start for another 2 weeks… so I’m sure I can at least get a good start on “Think Like A Pancreas”. My family did work with a diabetes educator when my brother was first diagnosed and that was tremendously beneficial. Of course the hands on experience over the years has been a good teacher as well… even if that experience has been painful.
I also do agree with you that some type of psychotherapy/counselling would be beneficial for my brother. In fact, I have recommended my brother try counselling in the past to no avail, but ultimately it is his choice if he chooses to go or not. I still plan to gently suggest though from time to time because I care so much.
And I will close my response by saying that yes staying in control is essential to minimizing these events… and I would contend that it’s the only way to minimize the impacts. If there’s one thing I’ve learned over the past 10 years that point comes right to mind.

Thank you again for your wonderful response. I wish you the very best as well. I’ll definitely be popping back from time to time- such a wonderful community on this forum.

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I’m glad you found my response helpful. As far as keeping the sensor on, some people on the forum have found a medical adhesive such as Skin-Tac works like a charm. I’ve never had adhesion problems myself but since some said the G6 glue was less effective I did some research to protect my investment: I found a G6 patch and some tale shaped to fit it, with a strap over the top - it gives me some extra security of I walk too close to a door frame (I’m a bit clumsy😫!). Not to worry, they come in other colors of he’s not into his feminine side.
With a couple of weeks you should be able to get through the book easily - some chapters are geared toward daily life while others, such as types of insulin and their patterns, may be more for general interest.
I really hope your brother decides to get counseling - and if he doesn’t you could get some on your own to help with his helping your dear brother affects you. If course the choice is his but in a few years you will both be out of college and hopefully moving into careers you love, which may take you both to different places. I don’t know about Addisons but there may be discussion groups or forums similar to this one for it, where he can connect with people who are managing it.
Best to you both! PS - I love your forum name!
PPS - there are some discussions on the forum that include Addisons - it looks like the most recent were from late last year but you never know what treasures you will find: https://forum.jdrf.org/search?q=Addison%20order%3Alatest

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Ah skin-tac! I remember that working like a charm for my brother too- so that is something I’ll be utilizing for sure, as it turns out I’ll be meeting my brother pretty frequently to help him with the CGM (my mother and I talked about this last night). It is great to know that there are alternates if the skin-tac ends up not working.
I hope my brother will start counselling- preferably soon but if he ends up doing it at some point far off in the future that would make me very happy. As long as he ends up going. As for me, I have been done counselling before and plan to resume very soon. And thanks for the Addison’s forum link that will be very helpful- as the Addison’s can complicate the diabetes management a bit.
Thank you again for everything! Take Care.
P.S.- Thanks for the compliment on my forum name- green tea and yoga are two of my favorite things.

I’d love to chat more!

I second the Think Like a Pancreas suggestion - great book! I purchased it the day or two after my son was diagnosed in June on a suggestion from this forum.

Maybe when your brother can open up a bit/accept his condition, he should pop on here every once in a while to ask any questions he may have as well. It’s a great resource and I’ve much reassurance here too.

Hey. I read the other responses. And they are fantastic! But I have one more thing to add. I’m T1D level 30… ( I say level 30 because it acknowledges the sacrifices, skill and burden to get there). Stop talking to him about diabetes and have him talk to you about his dreams. His wildest most outrageous desires. What does he want to build? Do? Be?? When we put our focus there. And REALLY get excited about it controlling diabetes has to happen or we’d never get there … start there. Changing mindset. Increasing possibilities. Looking at others who’ve reached a life he’d like to live with type 1. You can talk to him till he’s blue in the face. Won’t matter. Mindset needs to be addressed first. And that’s my two cents. I wish I had a family member that cares the way you do. Makes my heart smile and I want to send you a BigHug!

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Very excellent and wise advice!

First of all, you are an amazing sister, much like my own. I am so sorry that you have to deal with this. It’s tough, your poor brother, sucks to have to deal with these things everyday of his life, but he has a choice in this life he lives, and it will end poorly and prematurely if he does not start taking care of himself. Have the 2 of you sat down and had a conversation about how you feel and the anxiety that you carry? It sounds like counselling would be super beneficial for both of you. That stress is not good for your body and your health is just as important as your brother’s. Any time you want to chat or talk something through, msg me. I’m happy to listen, if nothing else :slight_smile:

Feel free to message me in the individual messaging function on this forum if you’d like!

I have started reading the book myself- a very wonderful read as the author writes in a very informative yet engaging style. It’s a wonderful resource.
My brother is stubborn and does not like to ask for help so the chances of him coming to this forum are slim… but maybe as he grows older he can overcome that a bit and pop on here from time to time.
Thanks for the reply and take care.

I have appreciated every response to my initial post… but this is probably my favorite response hands down. l absolutely agree with you and I think that is part of the problem…he is not entirely sure what he wants to do with his life. Granted he is young and still has plenty of time to think through things and figure things out. But still… I think even if he gets a hint of what he would like to do that would be tremendously helpful for him. The next time I see him I will encourage him to think that way.
Thank you again for your insightful reply (and the BigHug haha). Take Care.

Thank you for your reply. Yes, you are absolutely right and I have reached a similar conclusion through my own thinking. We have had a conversation like that before and it did not go very well. I have encouraged counselling in the past but to no avail sadly. I’m hoping one day he will go though and I will keep encouraging when appropriate. As for me, I do plan to resume counselling again (I have participated in it in the past) to talk about this very issue- the stress was taking a toll on my body. Thank you for your offer to chat I do appreciate that. Take Care.

Hey… been a diabetic a long time and get it. Ty it feels good when i can help. Also wanted to say. When he has a hypo he gets aggressive because the brain is in fight or flight. It has to choose what to process because there is a lack of sugar. So. Any light any sound any touching any hearing all takes a tremendous amount of energy to process when there isn’t enough energy for
The brain to process so that causes frustration. Add to that someone trying to force you to do something, like eat something, will not go over well because any aggression is seen at that moment as not safe so rejection happens and cursing and doing anything to ensure survival. Yes that doesn’t make sense because your trying to help. But at that moment it is seen as a threat. In the future try to lessen the bombardment. Sound light touch etc. be very non confrontational like you are approaching a hurt animal. Gentle soothing and suggestive. No pushing. No you must this or that. The brain says Omgoodness I’m in trouble high alert and chooses incorrectly… hope that helps. And I’m always here if you need anything. Ty for the hug back. It’s what I miss the most with this COVID !! Lol

Hi again. My ideas come in bits and pieces so please forgive me for chiming in here and there. Please don’t take offense - I certainly do not mean to insult your brother or anyone for that matter. But sometimes people think only about the effect their habits, addictions, or in this case medical conditions - have on themselves but not others. Our perhaps they don’t realize the difficult position they are putting someone in. Despite the lack of muscle control they may have during a serious low, some people can still fight off those trying to help them, possibly inflicting some damage in the process. One response suggested a gentle touch to prevent sensory overload (I hope I parphrased that correctly) but sometimes something more is required that not everyone is physically able to manage. I read somewhere - perhaps not on this forum - that some people have to see the cold reality for themselves in order to be willing to make a change; and making a video was recommended. I know - people tend to say “Why are they standing there recording instead of helping???” but if circumstances allow - if there’s someone else with you who can get that started and then give you help you need - your brother could see his reactions - no pun intended (fur this of us familiar with the old term “insulin reaction”).
From where I stand both you and your brother would benefit greatly from his going back on a CGM. It would give a head start to respond to lows before they get to the point where they could be dangerous for both of you, and perhaps seeing an episode would give him the kick he needs to reconsider that and counseling. Counseling in turn could also help him make some plans for his future, as someone wisely suggested, so he can count himself in the 20- 30- 40- or 50+ clubs down the road, incorporating our diabetes into the lives we’ve chosen to enjoy.

Hi @greenteaandyoga. I’m guessing classes have started and I thought about you and wanted to see how things are going. I hope you enjoy your year, even if it’s not traditional, and that things are looking up for your brother as well.
If you have a chance, with your workload, send us a note and let us know how you’re doing.

Hi @wadawabbit,
Thank you for reaching out. I did see your last reply from two weeks ago btw- very helpful. Thank you for taking the time to share your insight with that second post. Even though I am hard at work with my classes (which require more commitment and dedication than in-person classes in my opinion) the wisdom you share is something I keep in the back of my mind often.
My brother appears to be doing fine- working on his classes, living with friends who know him and his diabetes well. As for me, I am doing well enough considering these times we are living in. I take things day by day.
Thanks again for reaching out. Have a wonderful weekend.

So glad to hear the positive news about the both of you! Best to you in your studies. Time allowing (:flushed::crazy_face::tired_face:) keep us posted.