Yesterday was J's quarterly visit to the Endocrinologist. This is always stressful for us as parents because they do the A1C test which tells us his average blood sugar over the last 3 months and is almost a report card as to how well you're managing T1D. This average will tell us how at risk he is for developing diabetic complications.
Every Endocrinologist is different but J's range for his age is < 8.5 and higher than 7 to avoid having too many hypoglycemic episodes, as those are the most dangerous for small children.
It is a very delicate balancing act!
Since J's diagnosis a little over a year ago, we have always been within his recommended A1C range until......we went on the pump in December! At his A1C check in January he jumped up to a bit above the threshold. We felt terrible that we hadn't been able to have as good of "control" as we did with multiple daily injections and started to question if we made the right choice having him go on an insulin pump. We have been blessed with an amazing Endo that is more than just a doctor treating his patients, he is someone who actually cares and understands how difficult it is to live and manage T1D. He quickly assured us that he was in no way concerned about the higher A1C and that we were still learning the pump and it was completely normal and that he knew by the next visit we would be back on track. We left feeling a little better but also determined to have a better A1C the next visit!
Since that visit in January we have been working really hard to learn how to make the adjustments to the pump. It is a lot more complex than being on shots. Shots it was black and white: 4 highs in a row in the same category you increased the fast acting insulin dosage, 1 low in a category and you lowered the fast acting insulin dosage, high across the board you increased long acting insulin dosage, low across the board you decreased the long acting insulin dosage. Now, we are dealing with basal rates, insulin/carb factors, correction factor, reverse correction, special bolus options and they can all be fine tuned to mimic (as close as humanly possible) the function of a pancreas.
Well yesterday all of our hard work paid off and we dropped 1.2 points in his A1C and we are safely back in range (insert Happy Dance) We still have a long way to go in learning the pump life but at least we know we are on track and getting the hang of it! J's Endo also went over some of his Dexcom G4 CGM data that I brought to the appointment and showed us how to analyze them and make changes based on the trends of his blood sugar. We left feeling a million times better as usual and are looking forward to our PENS team visit next week to pick their brains even more and continue our pump education.
Take that Diabetes!
How do you handle getting your A1C "report card"?