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What BG's go with an A1C of 5.3%

Discussion in 'Parents of Children with Type 1' started by Darryl, Sep 3, 2010.

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  1. wilf

    wilf Approved members

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    No one is diagreeing with you.

    It all comes down to what one defines as "low", and how one deals with numbers in the 70s vs. 60s vs. 50s, vs. 40s, vs. 30s..

    Your definition of what a low is and how to response is based to a significant degree on your experience with your child's seizures.

    My definitions and responses are based to a significant degree on my experience of losing 2 people close to me to the complications of high BG levels.

    Hopefully we can each see and understand what the other is doing and why, and use it to help us with the tightrope walk that is diabetes management..
     
  2. wilf

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    I'm not saying I'm better qualified - why would you put words in my mouth?

    But I have the right to puzzle about and speculate on what happened just as her endo does, and I can state disagreement if I so choose.

    Nothing arrogant about it. It's called freedom of thought and freedom of speech.
     
  3. wilf

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    Maybe pointing out the obvious, but I'm hoping that given what you've been seeing you've done regular checks of your meters vs. lab tests on blood draws.

    If you have, then your child is an exception to the way that most children respond to blood sugar levels in the 60s and 70s.
     
  4. MamaC

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    Then my child is also an exception. Oddly, his endo, like Lee's daughter's, holds that sustained 50s and 60s are his danger zone, perhaps because HIS body's defense mechanism does not kick in until he is much lower.
     
  5. momtojess

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    Well, my speculation is her endo probably has a better idea of what was going on his since had all the information. And I am also going to specualte and freely say that some people don't want to believe such severe reactions can happen when BG is in the 50s and 60s. Its easier to turn your head than face reality.
     
  6. Lee

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    I just don't understand why this is so hard for you to believe. I am an intelligent woman who is diligent in the care of my child. And I am sick to death of being condescendingly told that what I have experienced cannot happen.

    Mine is not the only child. I can easily think of two more on this forum who have experienced similar situations. That is why it is important for parents to know that lows ARE dangerous and that they are just not something that should be treated with a lackadaisical attitude and a shoulder shrug.
     
  7. wilf

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    I'm going to end my participation in this conversation in this thread, as it threatens to hijack what was otherwise a pretty useful discussion initiated by Darryl.

    I will set up a poll in another thread to see if we bring some understanding to the question of when people's children start to experience symptomatic lows. There may be something for all of us to learn here.. :cwds:
     
  8. StillMamamia

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    I think we can all safely agree that, as much as we want to avoid hyperglycemia, hypoglycemia is another beast we want to stay away from, if possible, because D IS unpredictable, not matter how vigilant we are.

    So, the question remains how much lower should one be adjusting the "range" threshold, just for the sake of avoiding hyperglycemia, without putting a "Come hither" sign to hypos? Basically, how tight should we walk the rope? I think this is what several posters are worried about, myself included.

    And just because most children will react a certain way to moderate lows, this does not mean they will continue to do.
     
  9. MamaC

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    Might be good also to query regarding asymptomatic lows. Like the "LO" we experienced that was only identified by a scheduled post-soccer check.

    Totally.and.absolutely.asymptomatic.
     
  10. momtojess

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    Or you could just refer to this thread http://forums.childrenwithdiabetes.com/showthread.php?t=57346 where basically everyone who has responded said they treat a 70, not because the cwd feels symptomatic at 70, but to prevent going lower.

    edited to add, make sure your poll asks about asymptomatic lows too because there are alot of kids who don't feel them but that doesn't make the low any less dangerous,
     
    Last edited: Sep 6, 2010
  11. Lee

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    I am sorry, screw'em...NICE Swellman, Nice...:mad:

    I do not post my graphs here becuase they are not mine to post. My 12 1/2 yr old does not want to share her information. She asked me to stop a while ago, and I did. It is HERS, not mine...she also does not want us to say what her bs is out in public, or around her friends. WHY? Because we are constantly judging #'s - to high, to low, spot on...each # hold a judgment for her and how she is taking care of herself, how she is counting carbs, etc, etc, etc. She was actually horrified when I posted her chart showing a rebound about 6 months ago.

    I respect my child's right to the privacy of her disease...and screw all of 'em who don't.
     
  12. swellman

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    ... and the assumption that anyone else who does otherwise is doing it with complete disregard for their child's best interests is equally insulting.

    We get it ... we all know how you feel about lows by now and it's pretty obvious you, and others, came into this thread with your gloves off and throwing assumptions, implications and flat out accusations around. You can't take the high road now.
     
  13. Lee

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    I never made that assumption - that Darryl is disregarding Leah. EVER. I was defending myself against you who said that since I did not post my graphs, I have no room to talk. I was not the one who threw off the gloves - I was the one who pointed out how much total time Leah spends low. I asked Darryl questions about it. Did I have a personal agenda - of course I did! Everybody does - be it to learn something new, caution others about extended lows, or prove themselves to be narcissistic jerks...cough, cough.

    I was never, ever disrespectful to Darryl - and I never disrespected his answers. If you read my posts and Darryls posts you will see a mostly respectful Q& A session. YOU came into this thread and stirred up trouble, and on page 14 bought this discussion, that had VERY LITTLE negative connotation in it at all - into the gutter.

    YOU made a giant assumption saying that the only reason I don't post my charts is that they don't look as good...you told Darryl to screw'em. You brought the entire thread to a level of juvenile theatrics - but that is just in my opionion.

    I would suggest - before you start calling names and pointing fingers - you reread this entire thread from the beginning.
     
  14. Darryl

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    OK now, I think we're taking things a little to far in all directions. Just to be clear where I stand on this, I believe that the blood sugar goal for a diabetic child should be fasting 70-99, and post prandial up to 126. The same as a nondiabetic child. I agree with Lee that anything under 70 is low, and should be treated (which is why we always do treat, with both carbs and reduced basals, any low under 80).

    I also agree with DCCT and EDIC 30-year study results which continue to suggest, with each year's data, that people with the most aggressive and intensive control and lowest A1C's generally have the best health, cognitive, and emotional outcomes, despite more frequent hypos. As long as those hypos don't go to far. I would never subscribe to an BG control targets that would result in seizures, rebounds, or symptomatic hypos.

    Most of all I agree with Rella, who said it best, it's a tightrope and we're all in the same boat.

    I hope the data and the discussion have been helpful.
     
  15. swellman

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    That never happened. I have no idea what you're referring to.

    Not negative? Really? Daryl getting slammed for posting his child's private info wasn't negative? The "here we go again this thread is heading for the crapper" post wasn't negative? It even persisted after Jeff said "Great Job" as if the creator would have any idea what was and wasn't appropriate to be posted in these forums. :rolleyes:

    I have absolutely no idea to what you are referring. Again.

    I will just to make sure I'm not losing my mind.

    But, to be clear, that juvenile comment was directly addressing the notion that Daryl had no right to post the info and I find it inconsistent to post very personal info like severe reactions to hypos and physiological traumas while claiming it improper to post charts, graphs and A1c values.
     
  16. hawkeyegirl

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    Okay, just a couple of thoughts:

    1. I think there is a wide variation of "okay" when it comes to posting our kids' information on here. Some people don't even list their kids' names in their signatures. And some people have links to their FB pages in their signatures, where their walls are totally unprotected. Many people have posted CGM charts in the past and have not been lambasted for it. I think it's fine to NOT post that information about your child, but I also don't think it's inherently wrong TO post that information about your child. People post their kids' BGs on here all the time, seeking help, and no one blinks an eye at that.

    2. I don't think anyone on here is advocating running their child in the 50s or 60s or is saying that lows can't be dangerous. My feeling, and I've said it before is that ALL kids with diabetes are going to have lows now and again. And I think they're essentially unavoidable if you strive for an a1C in the area of 7 or so. They are not desirable, and they should be dealt with promptly, but they are sort of a necessary by-product of tight control. I think that for kids who wear a CGM, they are unlikely to result in "severe hypoglycemia" as typically defined. I further don't think that brief excursions into the 50s or 60s are likely to result in permanent damage. If they did, every adult with diabetes out there would be cognitively impaired.

    3. I've never understood why people don't find rebounds more concerning. I see people post that their child has had frequent rebounds, and no one chews their butt like Darryl gets his chewed. Leah has never had a seizure, lost consciousness or been so low that she rebounds, yet he takes an awful lot of flack for running her too low. Yet no one says anything when someone posts that they see rebounds in their child. I think of rebounds as one small step away from a seizure; maybe I'm wrong on that.

    4. Our endo has never, ever commented on 50s or 60s, and really never on 40s. He is much more concerned with highs when he looks at our numbers. Maybe that has unconsciously influenced me, but it's pretty clear that he does not find a few lows a week, treated promptly, to be dangerous. But he addresses those mid-200s every time.

    5. I am 100% sure I would feel differently about lows if I had had to watch Jack have a seizure. That's why the CGM is non-negotiable in our house, and probably will be until he leaves home. I have the "luxury" of having a child (1) be diagnosed young; (2) and getting him on the CGM early so that it's all that he knows. I don't know what I'd do with an older child. Run him higher, probably.

    6. I agree with Darryl that higher targets don't necessarily prevent lows. In our experience, it's highs that often cause lows through roller-coastering. The more level (and low-ish) Jack's BGs are, the fewer lows we actually see.
     
  17. Jeff

    Jeff Founder, CWD

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    Perhaps it's time to close this thread. The discussion has become more personal than educational.

    I would suggest that we all give each other the benefit of the doubt and assume that we're all doing the very best that we can in our personal circumstances.
     
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