Sorry for the length of this post in advance…
I know that’s hard to deal with. He may just be going through burnout. It happens to a lot of T1Ds who just get so tired of having to be mentally tuned in to their bodies all the time that they end up just not dosing or thinking about what they’re eating because it’s a bit of a mental break to not have to think about it constantly. You might think about getting to the root of the problem and asking him why he’s not dosing for things. Make sure he knows it’s okay to eat what he feels like eating (even if you don’t agree with his choices–which I know is hard). I remember eating zebra cakes ALL THE TIME when I was a teenager, even though I knew it was bad for my sugars. But because I felt like I had the freedom to eat whatever I wanted, I knew that it was fine because I dosed correctly and my sugar levels weren’t affected much. If you feel like he’s “sneaking” food, then it might be that he feels like it’s not okay to eat it?
Maybe try telling him that you know it sucks to have the disease and you’re really sad you can’t do anything about it. It is a huge mental strain, and even 12 years later (and with an A1C of 5.7), I still struggle with it sometimes. Maybe think about talking to him about the longterm effects (which I’m sure you’ve already done) and possibly showing him examples in the news of people who are living really long, healthy lives as T1Ds because they’re dosing correctly and then also people who have lost toes or eyesight or even their lives because they just didn’t do the simple things like take insulin when they were supposed to.
Remember that he might not be as receptive to talking about it with people who don’t actually have Type 1. Because people who don’t have it will never truly understand what we go through.
I’m not sure what your insurance is like, but my insurance covers a Dexcom CGM 100% because it’s considered preventive care. I really like it because even on days when I don’t feel like dealing with my diabetes, it forces me to. If I go high or low, I have boundaries set on my app (I just use the mobile version so I don’t have to carry around an actual receiver device) so that once my blood sugar hits either 70 or 200, then an alarm goes off. It will first vibrate, and then if I don’t look at the app to tell it that I’m aware of the situation, an annoying alarm will go off. I hate when the alarm goes off; it’s loud and obnoxious, so I generally pay more attention to where my sugar levels are because I don’t want to deal with the alarm. Maybe it would work this way for him, too? Even if he waits until he hits the high threshold he sets, the alarm will go off every 5-10 mins or so until his sugar levels start trending back down, which indicates he’s given a correction dose. This might be a great option for him!
I hope some of this helps a bit. If he’d like to talk to a Type 1 who had bad A1Cs for awhile throughout my teens, was on shots for the first 10 years of my diabetes, and who’s now successfully managing (most of the time) all that comes along with being T1D, tell him he can reach out to me. My name on Facebook is Hope Charters. My instagram/twitter/snapchat handle is @hopekyra.