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Young children's A1c range

Discussion in 'Parents of Children with Type 1' started by missmakaliasmomma, Sep 22, 2013.

  1. missmakaliasmomma

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    I do want her to be around 6 eventually. Lows are a problem for us since she seems especially insulin sensitive plus is veryyy hypo unaware. You wouldn't even know she was low when in the 40's. it's definitely a scary thing. I'm hoping once she recognizes lows and starts to try to do some of her care on her own (checking BG, knowing what the numbers mean) that we can lower it a bit due to all around good numbers instead of it being low from lows.
     
  2. Sarah Maddie's Mom

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    Why THAT number, is all I'm asking.

    Usually when people target a certain A1c it's in relation to their current A1c by %. So if my kid's A1c is 6.9% and I feel that we can tighten up the overnights or work on that breakfast spike and let's aim for a 6.6% next time. That would be a realistic plan, imo. But stating that you wanted your daughter at 6% seems totally arbitrary to me. So I asked.
     
  3. MamaC

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    Honestly...you need the CGM. This coming from someone whose CWD (admittedly much older at dx) resisted any device for over 7 years. It's a game changer.
     
  4. Mish

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    got ya. I will add this little tidbit and then leave it at that. I also wanted my child to be at 6 once. Then, puberty hit and we're now dealing with the reality of what hormones do to blood sugars. ;) I wish I had never made such a goal in my head, so adamant with myself that some day I would get THAT good at diabetes and we'd get to that goal. I'm not saying "settle" for bad blood sugars, do the best you can, but I'd just caution you about having a goal that almost no one can reasonably meet .

    And, I know, right now you're saying to yourself, "I'll show her. I AM going to be the mother who can do it." And I will tell you, I also said that. :D
     
  5. Shopgirl2091

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    I agree about the CGM - you definitely need it, and this coming from a Mom of a 4 year old who is extremely hypo-unaware. It will not only help you with tighter control - but for us it has been a life-saver many times catching lows that I would never ever have known about until it was too late.
     
  6. nanhsot

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    LOL, I kept typing and deleting a similar reply. By the time a kid is more aware of their BG/hypos and more involved in their care, they are typically in the throes of puberty! Hormones, sports, eating at all hours of the day, being a typical preteen/teen. Yep. It's good to have goals, but living reality is more important. And having a good parent-child relationship is very important, I personally don't want to achieve a number at the risk of having to run rigid in this area. We hover around 7 and are thrilled with that. I don't have a young child though, so I realize that isn't answering your question at all. Our endo is happy with anything under 8 and thrilled when he's been under 7, but that's for a teen, not sure on the younger kids.
     
  7. nebby3

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    We also go to Joslin. Not sure if things have changed but when my dd was a toddler her goal (they said) was 8.0-8.5. I think it was around age 5 or 6 that they began to say under 8.0.

    Some people just seem to get better a1cs. Some of us work our butts off and don't reach those lower numbers. I would caution against comparisons. No two kids are alike.
     
  8. missmakaliasmomma

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    Haha normally id want to "show you" but not at the risk of risking more lows... I am sooo not looking forward to puberty :eek:
     
  9. missmakaliasmomma

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    Oh ok,I say 6 because I'd like her to eventually get there
     
  10. MomofSweetOne

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    I know you've had a bad experience with trying the pump. The CGM is so different. I would guess within 3 days of a Dexcom G4, you'd wonder how you ever survived without it -- and your daughter will be thrilled to have less finger checks.
     
  11. Lee

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    I also think hoping for a six, especially without the technology, is just setting yourself for many years of feeling like a failure. After the first few years, I stopped hoping for a number and started hoping for a target of healthy.

    What I really came here to say though is that Low Awareness is something that is not learned, and it comes and it goes all the time. Honestly, the lower the A1C, the less likely she is to catch her lows, because her body is used to her running in a lower range. There are times when my child will wake up from a low and there are years where she can't feel a 38. There isn't anything to learn - it is all about how the body reacts - what hormones it dumps out in response to low.
     
  12. Caysie98

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    I'd just like to say that it IS possible to get an A1C in the lower 6s. Since your daughter is young and isn't aware of her lows, it's probably better to aim for the 7s right now, but once she gets older and is more aware and in control of it herself you can start aiming lower. I'm 15 and my A1C is 6.5. I don't use a CGM but I (almost) always feel my lows now and I check throughout the day. I also use a pump. I know you've had trouble with it but I think you should try it again in a few years (and try a different one). Different basal rates throughout the day and temp basals are very helpful. My friend who's a year older than me has an A1C of 6.2. It IS possible, and goals are good. :)

    Good luck
     
  13. hawkeyegirl

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    What do you see as the downsides? Maybe the folks here can address those for you. The vast majority of parents fall in love immediately.
     
  14. missmakaliasmomma

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    It actually being on my daughter is the downside. We didn't like the pump for this reason- it got old quick. She had to be careful about bumping. A couple times she fell on her butt and the cannula kinked.. It was just really annoying. She's so happy on shots and I just don't know if it's something that I really want to piss her off with now. Another thing being attached to her. Because dex has a larger profile than pump sites, I don't really even know where I'd put it- stomach is a definitely NO according to my daughter. You can't come within 10 feet of her without her screaming if she thinks it's going in her stomach. Her arms bruise easy (we had that problem with shots), Her butt is always our best bet but I don't know if it will fit under her jeans.

    I'm sure it doesn't hurt to try to just see how she feels with something attached to her again.
     
  15. hawkeyegirl

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    I promise you that you can't kink a cannula by falling on it. ;) My son has worn a pump since he was 4. Through baseball, basketball, soccer, THREE seasons of tackle football, and no problems with kinked cannulas. It's just not that sensitive. He has worn a CGM through all of that too, and I think we've lost maybe 3-4 sensors to being ripped off in 5.5 years of CGMing. If you want to make it work, it's not a problem. If you go into it not wanting to do it, you will be able to find enough problems with it that you will fail and your daughter won't like it either.

    CGM is going to become the standard of basic care, and a 4 year old is much more adaptable and pliable than a 14 year old. I'd get one on her sooner rather than later. We started at 4, and it's all my son knows, thank goodness.

    I'd use her arms. The Dexcom sensor is tiny. It basically leaves no mark.
     
  16. nebby3

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    My dd's the same way -- she pumped for five years and now refuses to wear anything. She has tried a CGM as part of a research study and has no interest in it. While I'd love to be able to get lower numbers, it's her disease and I'm not going to force her to wear something. Btw her a1cs only got lower when we stopped pumping.
     
  17. nanhsot

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    Yes, this. Thanks for saving me some typing. Full on tackle/high school level football~~starting on offense and defense and a team captain, running track, trampolines and kickboxing and I could go on and on. Though my (somewhat vain and good looking, ha) son refuses to use his arms, he uses legs/thighs only.
     
  18. Sarah Maddie's Mom

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    Must echo this. ^ If you can get past your obvious anxiety about your dd wearing a device, it will go a long way to helping her succeed in wearing a device, be it a pump or a cgm. Given your desire to obtain optimal A1cs I'd push for the g4 first.
     
  19. swellman

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    I agree here.

    I couldn't possibly tell anyone that they could safely achieve an A1c of 6 without technology. In my opinion it's just not possible - the safe part.

    That having been said I guess it it theoretically possible with very severe restrictions on carbohydrate consumption.
     
  20. wilf

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    A1Cs between 6 and 7 are potentially achievable on MDI or a pump, and more easily achievable with a CGM.

    BUT the goal should not be to hit a certain A1C. The goal should be to have a happy healthy child who has reasonable numbers and has made peace with their diabetes.

    Striving for the lowest possible number (which we did for quite a few years) can come back to bite you when your child hits their teens.
     

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