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A1C

Discussion in 'Parents of Children with Type 1' started by Dvbo79, May 21, 2013.

  1. Christopher

    Christopher Approved members

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    I don't think I will ever get over feeling upset when I read comments like this. Yes, I do understand that there are certain challenges trying to manage diabetes in very young children, and yes I agree wild fluctuations in bg levels are not good (for any age), but for a doctor to advise parents to purposely let their children have prolonged high bg levels, to me is just negligence.

    A doctor once described to me what the effect of high blood sugar was on the body by saying it is like having a bunch of little glass shards floating around in the blood stream and travelling to all the organs in the body. I have never forgotten that image.

    So instead of simply telling parents to run their child's bg high, how about putting in the extra work to figure out ways to address the highs while still mitigating the risks of going too low? It can be done. So why aren't they doing it? Are they just trying to cover their ass? Is it just laziness? Do they think they are making it easier on the parents? Whatever their "reasoning" is, I don't agree with it.
     
    Last edited: May 24, 2013
  2. Sarah Maddie's Mom

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  3. Jennifer126

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    I have no idea anymore but they have told me to lower his carb ratio every few days. I feel like the more I lower the higher he goes sometimes... or that I don't see any change at all. So confusing.
     
    Last edited: May 24, 2013
  4. shannong

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    This has been my experience with my son's endo team. Always wanting to take a very conservative approach and wanting to run kids at higher numbers. I think there are signs of change though. I know that the Canadian guidelines have lowered the A1C targets for children of all ages.
     
  5. hawkeyegirl

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    There are some published journal articles out there about the imperfections of the A1c test. I don't understand the science, but basically, the same average BG can produce wildly different A1cs in different people. If I have time later, I will Google them and post a link.

    I'd also note that although your 10 months since diagnosis probably feels like a lifetime, in D-time, it is not long at all. :eek: My son has been diagnosed for 5.5 years now, and I can tell you that I am a heckuva lot better at this now than I was 10 months after diagnosis. Not that I'm some D guru or something, but my instincts have improved so much, and my ability to deal with weird situations or unexpected situations is so much better now than it was that first year.

    There are so many other things that factor in too that it's really not worth worrying about whether some other child's A1c is consistently lower than your child's. I've read many of your posts on here, and I can say confidently that you are doing a very, very good job for your son. And that's all anyone can ask - you take the hand that you're dealt (age of child, child's diet, child's normal activity level, child's personal biology) and do your best with it. :eek:
     
  6. kirsteng

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    I couldn't agree more with this.

    That's why I say that I'm a bit of a maverick.. I don't adhere to the age guidelines for my child. My aim is 4-7, like everyone else's bg targets. I am however, ultravigilant for lows.. and I do have the luxury of having an easy-going little soul who will listen to my gentle reminders to eat less at one sitting, avoid certain foods at certain times, exercise a little after meals etc. I don't think it would be possible with other personalities (like my first born son, for example). ;)
     
  7. SarahKelly

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    I completely agree with you, and the sad part is that when you as a parent of a young child with t1d tell the endo team that you will diligently check and respond to BG appropriately for your child than they should respond, but they don't at first until you prove to them that you can handle it. I felt like we had to go off the endo orders very quickly and make quick adjustments based on guidelines for older children rather than younger. I am still amazed at how surprised the nurses seem at Isaac's A1C, it does take a lot of "work", but it is also manageable. I often feel a little despondent that they're not empowering more parents to help their young ones with t1d have more in range numbers. I do however think that the major issue for young children is that without an insulin pump it is very difficult to accurately dose a small child, many endos aren't prescribing diluted insulin and therefor the choices seem to be to wait until BG get high to make a correction or give guesstimated "whiffs" of insulin. It is hard. I know...
    So, at first the goal is to just keep getting the A1C down, figure out what works and then start making more drastic changes when the parent feels comfortable. At least in my experience.
     
  8. Jennifer126

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    Here is the deal with small children. Their hear beats at three times the rate as ours does..... so everything happens three times as fast. And as if that isn't difficult enough, they are unpredictable, and these are the years when they are exposed to and get more colds and such. They have tantrums which lower their bg.... so let's not totally discount the doctors. Lows happen faster and these little ones can't always tell us how they are feeling. Letting the kids run a little higher while the family adjusts and begins to feel more comfortable is a calculated risk. My endo team responds when I call and are very reassuring. The feeling I get is that they want to circle down closer and closer. They realize that my Joe has had many outside variables and they are taking it slow with us. He has to ride out a lot of colds because he has allergies to medications..... I can see that the team feels that we will have him on track soon but that it's going to take a bit more time and they want me to know that it's ok. If we take it slow and steady we won't end up in the hospital too often.
     
  9. cdninct

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    Agreed. K's a1c would horrify a lot of endos (luckily, not ours) because it is quite low, but I put the work in to keep it that way. Does he have lows? Yes--more than I would like. But as a preschooler, I get to keep him close to me most of the time and head things off before they become serious. I consider this a great time in his life to try to achieve tight control because I don't have to worry about school teachers and nurses being vigilant or the effects of puberty! Damage is damage, and I aim to minimize it!
     
  10. mmgirls

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    As a parent that was nieve enough to think that my daughters care was individualised and being managed by the best, to then take the reigns myself and get better results than the people with a lot of letters infront and behind their name: I give this advice to parents that have not yet done so.

    If you are constantly annoyed with the numbers, feel like you wish you could do more, or you hate to be just leaving a high number: do somthing about it.

    Get books and read, ask questions or parents and dr.s, don't just accept that it is the way it has to be.
     
  11. DavidN

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    Thanks. I appreciate it.
     

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