Tuesday, January 11, 2011

Kind of scared...

We have Aiden's A1C appointment coming up and I am just scared to death that it will still be 10 and it is just making me worry about everything. Plus, Aiden's blood sugars have been pretty wonky lately and he seems to be needing quite a bit more insulin to stay in range.  So... I have a lot of questions.

--this is just a little backstory--You know from our Diabetes meme that we are very "Vanilla" what with our 2 units of Lantus a day. Well, recently we moved up to 3 units a day and for about the last week or two, we have been having to give a unit of Humalog here and there everyday as well. It was stressing me out, but as I was ringing in the new year (actually it was just my alarm on my phone ringing to wake me up for the midnight blood sugar check) I just had this epiphany that 1. things were changing RIGHT NOW and 2. that things were always going to be changing. I can't expect to get used to something, because then we will have a growth spurt or something else that will just cause it to go haywire. Now, don't get me wrong. I pay attention... I have heard EVERYONE in the DOC talk about this change, but for some reason, it just clicked with me that night that we are currently in that time of change. So now I am trying to actually go by the carb/insulin ratio and sliding scale that we were given by our Endo and it's working. YAY!

Now for the questions... With our appointment coming up, I asked our Endo in our weekly emailing in the blood sugars, if we need to do anything before we come, like getting the blood work for the A1C or did we need to bring anything. He just replied "Bring his log books". I thought "AUGHHHHHHHH" What log books? I just log all of his blood sugar numbers into excel and then make a note if we had to give Humalog in addition to the Lantus. I haven't recorded everything thing that he has been eating since about 2 weeks after coming home from the hospital. Do you think that is ok? And we always just stick to the 10 g. carbs for snacks and between 30-45 for meals and I make a note if we don't do that (i.e. birthday cake or something). So do you "Loggers" log the number of carbs in addition to the blood sugar? OR do you write down everything they eat? I remember seeing some posts on logging, but I guess I need a refresher.

And with the A1C appointment, do they usually draw blood then or do they use the meter? Or maybe different Dr.s do different things.

And one more thing... I still don't think we are ready for pumping, but I am really thinking about the CGM. I have heard tons of pros, are there any cons besides the obvious of having somthing attatched to him 24/7? And Matt and I are really interested in the Omni Pod. Laura (or anyone) - can you use a Omni Pod CGM and not the pump?

Thanks guys! It really helps to know you are out there to ask! Love ya!! (((Hugs))) DOC style!

3 comments:

  1. I don't have advice about the A1c since we haven't had one done since diagnosis. I am going to bet everyone will say not to worry too much. Get the number and then move on. It is just information about where you have been and a starting point for a plan to move forward.

    About logging, I too keep an excel spreadsheet and just plug in Ellie's blood sugar numbers, not her carb counts or food. Our Endo is fine with that, & I bet yours will be, too.

    Deep breath and then a long and slow exhale. No worries, Mama. You take great care of him and do what works for you guys. You got this!

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  2. I know a few people who use the Dexcom and MDI. Omnipod isn't appealing to us, so I can't help you there -- sorry :(

    We use the Ping...if you're interested, here's why...if not -- fuggetaboutit :)

    http://www.candyheartsblog.com/2010/10/animas-ping-our-pump-choice.html

    As for cons to the Dexcom...after 5.5 years with D, my daughter JUST started wearing it last month...

    1) It's only FDA approved for sensor placement in the belly. If she's sleeping on it or there's a bunch of blankets, it becomes very inaccurate. We use the arm with much better success. I feel like we waste a sensor when we put it on the belly, because it's only helpful half the time.

    2) It doesn't keep up with rapid swings. If she's rising or falling fast, the readings are usually pretty off. I'm trying to forgive this, but really wish it was more "real time"

    3) With #2 in mind, interstitial glucose readings do lag behind blood glucose readings by about 15 minutes. SO...I guess there's nothing that can be done.

    4) Acetaminophen (Tylenol) affects interstitial glucose readings. It will cause the CGM to be very inaccurate. Motrin is the only option for OTC fever/pain reducer.

    That's all I can think of for now.

    I did a post earlier this week -- we're trying to decrease the post breakfast spike. It's an example of how a CGM and a pump can work together to help you manipulate insulin...

    http://www.candyheartsblog.com/2011/01/super-bolus.html

    Good luck on your journey!

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  3. Do not worry about your endo appt! The A1C is just a finger poke that they do at the office when you go for your visit - no biggie.

    Don't worry about not logging carbs/foods eaten either. I did that for the first bit and the endo never even looked at them. He usually just looks at the BG numbers for the last two weeks and makes recommendations based on that. I remember thinking, "Why in the devil am I writing all this stuff down if he doesn't even look at it?!" I think the "loggers" do that so they can see if there is a pattern due to certain foods or certain times of day, but I don't think your endo will expect you to do that on an ongoing basis.
    I like what Amy said, the A1C is just information that helps you know where to go next. Good luck!

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