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Endo says control is "too good"

Discussion in 'Parents of Children with Type 1' started by coni, Feb 2, 2009.

  1. Nancy in VA

    Nancy in VA Approved members

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    I think that if your meter average and your A1C are close, then you're catching most of the lows and you are probably ok. If they are pretty far off, I would worry that there are uncaught lows. Uncaught lows are so much more dangerous than highs, and I think that's what the Endo is worried about.
     
  2. bisous

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    I asked a similar question not long ago. Our A1c is usually between 6.0 and 6.3. Our endo is happy with our results. We test frequently and don't have very many lows. That said, there is a discrepancy between meter average and A1c. I don't know if there is a really good explanation for that.

    One thing that scared ME was catching a low in the middle of the night only an hour after usual checks. That was really bizarre and disconcerting. I've since taken to do random checks at unusual times just to make sure that there aren't periods of time with regular consistent lows.

    Here's the way I look at it. We aren't attempting to have a BG of 80 all the time. We're just trying to stay in our range which for us is 70 to 120 or so. If he is outside that range, then we correct. I find that if we are high for any period of time that I have a HARDER time getting and staying in range than if we have tight control and test frequently. For example, this weekend we had a really weird occurrence with our pump that sent DS into the 300s (with moderate ketones!) Getting control after that event was really hard--we had a lot of yo-yoing (word?) going on. Once he was finally stabilized, he was easy to control again!

    I'd say try some random checks and then not worry.

    Sorry this is rambling and HTH,
     
  3. badshoe

    badshoe Approved members

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    Our endo starts talking about being hypo unaware at 6.7 or so. The worry is that younger folks don't feel lows until they are way low.

    As usual our pal Wilf is right on the money be sure you child is feeling and responding to lows in time to keep the uber lows at bay - Rock on
     
  4. Denise

    Denise Approved members

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    While I dream of an a1c lower than 8 ...my endo would freak if Molly's a1c was lower than 7.5 it's a YDMV thing...
     
  5. bkfkmc

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    Coni, we use the same group but different Dr. Our Dr. has had nothing negative to say. Braden's A1Cs have been in the upper 5's and 6's for a couple of years now. Obviously, every Dr. is different, even within the same medical group. I have been told that they rarely see A1Cs this low- so I'm sure your Dr. is skeptical when she sees lower numbers. Our meter average is usually higher than our A1Cs for the same reason. I never re-check low numbers, but almost always recheck higher numbers before giving corrections, thus skewing the average. I think it is entirely possible to have the A1C that Esme has and not have undetected lows. Test more if you are having concerns or doubts that she may be having undetected lows. You are doing a great job!
     
  6. saxmaniac

    saxmaniac Approved members

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    50 points is a pretty tight window. Is your target to 120, or down to 80? Our pump will only correct to a target, not the edge of range. Our rx range is 80-120 and I aim squarely for the middle, 120, and even that might be a hair low at times. If I set it any tighter than that we get way more lows than we already do!
     
  7. Darryl

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    This is very well put.

    Obviously no one wants to create a low A1C by having excessive low's, but if low's are infrequent and A1C is good, on what basis is the Endo being critical?
     
  8. bisous

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    Scott, we have ours set to a certain "range" (70 to 120). But his sensitivity is 300 so in all practicality, it will not issue a correction for anything under 150. Does that make sense?
     
  9. deafmack

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    I think it is possible to have an a1c below 7 without having a lot of lows. considering the a1c is the average of blood glucose levels over the past 2 to 3 months, I can't see anything wrong with it. I think you are doing a fabulous job. Celebrate:)
     
  10. coni

    coni Approved members

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    I'm glad you posted. I actually wondered about you guys as I thought this over. I knew DD couldn't be the only patient there with an A1C under 7!

    I think the endo was giving me a standard line, but I do think it's worthwhile to do some random checks just to make sure.

    The past few days DD's seen a few 70's, which I'd personally not like to see much, especially given the possibility of hypo unawareness Badshoe mentioned.

    I am considering finally using the Dexcom we got just to make sure DD is safe. I think she is, but I don't know for sure.

    Thanks everyone for your responses. You've been very helpful.
     
  11. mmgirls

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    Well if you have the Dexcom, and are willing o utilize it then I would say forgo the random testing and just use the cgm. As long as you are able to calibrate you will be able to get all yor data there.

    Good luck.
     
  12. saxmaniac

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    Yeah, makes sense. I'm wondering if your pump corrects to the bottom, middle, or top of that range. It has to pick something to target for (BG - Target) / ISF.

    On the Pod there only is ever a single Target, but there's a "correct over number", and will only do a correction. We have our target set to 120 (the middle of the Rx range) but the correct-over is 140. So if a BG is 139 it will not correct. If it's 150 it will then target 120.
     
  13. hawkeyegirl

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    The MM will correct a high to the top of the range and a low to the bottom of the range.
     

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