- advertisement -

First a1c post pump start

Discussion in 'Parents of Children with Type 1' started by Jenneve93, Aug 8, 2012.

  1. Jenneve93

    Jenneve93 Approved members

    Joined:
    May 12, 2012
    Messages:
    107
    Three months post pump start and his a1c went up. :( He was 7.1 at his last appointment before starting on the pump. Yesterday at his 3 month check, it was 8.0. Doctor made some changes to his basals and meal ratios, but as of last night it wasn't looking too promising. 2am check his bg was 298! 6am check it was 243. *sigh* Hopefully things will look better next time.
     
  2. Jenneve93

    Jenneve93 Approved members

    Joined:
    May 12, 2012
    Messages:
    107
    Not sure why my signature isn't showing up. My son is 13, diagnosed 11/17/05 and pumping with the Ping since 5/15/12.
     
  3. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    First, it's not a report card, so just acknowledge that number and move on. Take into consideration two things...
    The time of the year you transitioned...right before summer break. Schedules are always off in the summer. Does he take it off to swim?

    His age, he's still growing/changing

    I wouldn't get too hung up on it, but I would make sure you are logging everything, the Diasend program is great for downloading to.
     
  4. Jenneve93

    Jenneve93 Approved members

    Joined:
    May 12, 2012
    Messages:
    107
    Thanks for the encouraging words. :) We've actually not been swimming much this summer, but when we have he keeps the pump on. He only took it off once (the first time) and it was horrible. It was only off about 30 minutes, but then the new site didn't go in right. By the time we realized it, his bg was way high and he had large ketones. Since then we've kept it on during swimming.
    Our summer schedule is actually not much different from our regular schedule. We homeschool, so life doesn't vary much day to day.
    I do believe his age & puberty are huge factors. That and just trying to get all the basals and ratios worked out. With puberty that's not easy since it seems to change from week to week, sometimes day to day.
    His a1c's have pretty much always been in the 7's range with the occasional 8. Once it was 8.3 at the highest. I just hate seeing it higher than I would expect. It's a little disappointing when you know you're putting in all the work and it's still not as low as you'd like it to be.
    The CDE challenged him to commit the next 3 months to making sure he gets his insulin before eating, something I've been trying to pound into his head for the past several years. She lectured him pretty hard about it. She's certain that his waiting until after he eats to get his insulin is a huge factor in his a1c being higher than expected. I tend to agree. Hopefully hearing it from someone other than Mom will be just what he needed.
     
  5. Helenmomofsporty13yearold

    Helenmomofsporty13yearold Approved members

    Joined:
    Oct 5, 2008
    Messages:
    702
    The same thing happened here when DD started pumping. Puberty, growth spurts, eating continuously with the freedom to eat without doing a shot, how much BG's shoot up when there is a problem with a site, not changing site before it stops working, teenage moods; there are so many variables. The teen years are tough and an A1C of 8 is actually the envy of many a teen. Try not to feel guilty and disappointed. Our endo says pre-bolusing for meals drops A1C's by .5. It is not unusual for teens to not be good at remembering to do that on their own until they are a bit older than your son.
     
  6. hawkeyegirl

    hawkeyegirl Approved members

    Joined:
    Nov 15, 2007
    Messages:
    13,157
    If he doesn't want to decide before he eats exactly how much he wants to eat, have him prebolus something like 40 carbs, and then bolus the rest afterwards. That alone can make a huge difference. :)
     
  7. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    This is what our nurse challenged our daughter to do, and we are seeing results. It really does help.
     
  8. heamwdevine

    heamwdevine Approved members

    Joined:
    Feb 18, 2009
    Messages:
    698
    You guys will get the hang of it. Once you get the basal narrowed down a little better Im sure it will drop for you. 2 hour post meal checks/corrections also helped us with keeping the A1c down.
     
  9. Mimi

    Mimi Approved members

    Joined:
    Dec 19, 2008
    Messages:
    1,906
    Just wanted to let you know that dd's A1c also went up after pump start.

    This is exactly how I felt.
     
  10. Ali

    Ali Approved members

    Joined:
    Aug 1, 2006
    Messages:
    2,223
    This is such a reasonable and logical way to deal with stuff that I can not believe that it is just not a standard guideline, regardless of using shots or a pump.:cwds:ali
     
  11. Flutterby

    Flutterby Approved members

    Joined:
    Nov 11, 2006
    Messages:
    14,623
    Prebolusing definitely helps..

    Don't be so hard on yourself. Starting the pump can be difficult, it doesn't 'fix' anything overnight. Summer definitely throws a curve ball in there too. As others suggested, prebolus, even a small amount will keep that spike from going even higher. We use 20 as a starting point, if she's really high or having food that will absorb fairly quickly or a favorite meal where I know she'll eat a lot we'll up the pre-bolus, if its a slow absorbing meal, or she's on the lower side we'll do the 20, if she's low, we don't pre-bolus, but we don't wait for her to finish to bolus either.. typciall we bolus three times per meal (while at home).. a prebolus, a bolus in the middle and then one at the end if its needed.
     
  12. MomofSweetOne

    MomofSweetOne Approved members

    Joined:
    Aug 28, 2011
    Messages:
    2,747
    None of the A1Cs done here since pump start last September have matched the one done during the last endo visit before pump start. Sometimes I feel guilty that we have these expensive "toys" and can't match what we were doing before, but then I remember that the month after that endo visit is when puberty really kicked in and realize that while the A1Cs currently are about .4 higher than the best one, they would be much, much higher without the flexibility and ability to adjust doseages within a fairly quick amount of time. So, if you just look at numbers, we're not doing as well, but when you factor in life and puberty's extreme challenges, we're doing just fine.
     
  13. Jenneve93

    Jenneve93 Approved members

    Joined:
    May 12, 2012
    Messages:
    107
    Thanks, everyone, for the advice and encouragement. He's been doing pretty well with prebolusing. I do think we're going to have to make some more adjustments with his basals because he's still running higher than I'd like, but I'm not sure where just yet. I'll probably call the endo's office tomorrow and see what they think.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice