Worst A1Cs since diagnosis.
Yup – it’s true. I suspected due a few recent infusion site failures, missed corrections, and missed meal boluses for both kiddos that we would indeed have higher A1C’s than we did in November. Once you factor in Thanksgiving and Christmas food consumption – time off school resulting in a nearly laissez faire attitude by everyone except the Diabetes Nazi (that’s me) – we were bound to have gone up despite my efforts to pre-bolus, increase basals, reduce between meal snacks, etc. both kids were higher – nut just higher but the highest either had been in years.
I try not to take it personally – but how else should I take it? I promise I have and never will judge another parent or patient regarding their kids or their own A1Cs – God knows I wouldn’t want to be judged by others but that doesn’t mean I will sit by and shrug it off. I will make promises to myself to download meters and pumps weekly – double check that corrections and meal boluses are done promptly and correctly (what was I thinking not following up with my 12 and 7 year old to be sure that they heard me say – “do a correction” “dose for that” over iCarly and Spongebob. Who can compete with Spongbob?) and discourage the spoonfuls of Nutella (I admit it is goo but I don’t buy it – my dh does). It isn’t that they don’t dose for their nutella – it is having them understand that 2 TBSP does not mean a heaping serving size spoon.
On top of the A1C smack to the face my dd has been insisting that she wants to go back to shots and take a break from the pump. Thus we left the endo’s office with insulin pens. Lord help me – I feel I am a smart person. I am educated – the state of Texas even says I can teach children. But going back to doing all the math that goes with shots – I can’t get my brain to function before 4 cups of Joe in the morning – AND worse – my daughter – who is a math superstar (advanced courses in school) has a difficult time remembering to empty her lunch box everyday after school among other things. I know she can do the math but her remembering to do it is another thing. I know there are lots of adults and kids that do MDI and have fantastic results. Some may do it because using the pump is more costly and not all insurance plans cover it well if at all. Some may not like the idea of being tethered to a pump. I know there are lots of reasons. My daughter tried to sell me on the idea of returning to shots as follows:
Me: “You don’t need a snack, you just ate. If you must have a snack can you make it a free snack? All this snacking in between meals can be hard on your body.”
DD (yelling – thus caps) “THAT’S WHY I WANT TO GO ON SHOTS!”
Me: “you don’t need to yell. We can have a conversation about it without yelling. How will going back to shots stop you from snacking?”
DD “I wouldn’t snack if I knew Id have to take a shot.”
Me “Why not just choose not to snack now?”
DD “I can snack now because I use the pump. If I didn’t have the pump I wouldn’t snack and I would get better control.”
Me “Your logic is flawed. You can’t rely on your insulin therapy method to teach you impulse control and better food choices. Why don’t you just make better choices.”
DD stomps off and says that I hate her.
The biggest problem here is she has inherited her fathers logic and his lack of will power. ie. If the snacks aren’t in the house he won’t eat them. Thus – both admit that they have zero impulse control. That will not serve her well as she grows and has to take care of her own D.
At 8:30 pm she received her first Lantus shot in nearly 3 years. It was 10 units and I won’t be sleeping tonight at all. It didn’t help that we ate Olive Garden tonight and we clearly under counted carbs – she was 410 at 10:30 (3 hours after dinner dose). Thank goodness we used the pump to dose for dinner so at least tonight I could put her BG in the pump to determine her correction dose that I would be giving with the Novalog Pen. I can easily do the math but the who IOB thing is beyond my math skills – at least until I figure out at what rates the RAI breaks down.
Worst Part of today – We got the Trial Net results back regarding my non-diabetic son that agreed to be tested at our local JDRF Walk to Cure Diabetes in October. The results – all positive (and I don’t mean positive news). I knew they would be based on random BG tests I have taken from him. Also, on how really fast acting carbs like candy effect his mood. Most of the time his BG numbers were within range. A handful of times he was above normal but not far enough above to check him into the ER. Also his A1C (yes my dear endo has been kind enough to test him for me) has not been above 5.1. Yet here sitting on my desk next to my late night cup of Joe I have a page that clearly indicates that he is at a much higher risk of developing Type 1 than others.
Sometimes I really do wish I was a person that could relax with a glass of wine – I’m not. I’m more of a venti non-fat cinnamon dolce latte with only 3 pumps of syrup and no whip kinda gal.