EDITING IN THAT WE GOT THE RESULTS OF HIS *LAB DRAWN A1C*  and it was 5.2%  So Jesse is just fine and I am very thankful!!!  :-)

This is a Bayer home a1c test kit.  What is an a1c test: 

The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c.

The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control. And if you have previously diagnosed diabetes, the higher the A1C level, the higher your risk of diabetes complications.

For someone who doesn't have diabetes, a normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 9 percent.

When the A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes.

For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications.

Here's how A1C level corresponds to average blood sugar level, in milligrams per deciliter (mg/dL) and millimoles per liter (mmol/L):

A1C level	Average blood sugar level
5 percent	80 mg/dL (4.4 mmol/L)
6 percent	120 mg/dL (6.7 mmol/L)
7 percent	150 mg/dL (8.3 mmol/L)
8 percent	180 mg/dL (10 mmol/L)
9 percent	210 mg/dL (11.7 mmol/L)
10 percent	240 mg/dL (13.3 mmol/L)
11 percent	270 mg/dL (15 mmol/L)
12 percent	300 mg/dL (16.7 mmol/L)
13 percent	333 mg/dL (18.5 mmol/L)
14 percent	360 mg/dL (20 mmol/L)

So--if you went by all of the information above, an a1c result of 6.6 for "Thing 1--my diabetic daughter" would be GREAT!  It would mean her blood sugar is fairly in control and she is doing good.  Hers usually runs in the 7 to 8% range, which is okay for someone her age.

The above a1c test, however, was for my 23 month old son, Thing 6.  I thought hard about even writing anything about this, because I just don't know for sure yet.  He went into the lab and had a blood draw for lab tests done today.  I will hear in about 7 hours what the results of that a1c are.  And I will know how accurate the home a1c test kits are.  I used one for me once, it was 5.5%  A week later I had the same test done at the lab in town and it too was 5.5%.  So in my one instance it was spot on.  So I'm pretty anxious to know what the result is in the morning.

Thing 6

Something new our way comes

In my last post I wrote a tiny bit about the Dexcom CGMS and my hope to acquire one.  We are 1 step closer to that goal, but it's a tiny step.  At least it's a step forward and not backward.

When Elizabeth sees her pediatric endocrinologist, Dr. H, in a few weeks, we are also going to see the CDE (certified diabetes educator) first to get a trial sensor inserted.  You wear the sensor for 3 to 5 days and then mail it back to the doctor where they hook it up with their machine to give you the readout of what the blood sugar levels did 24 hours per day.  It takes a reading every 5 minutes 24 hours a day.  The sensor they use in this trial is from a different company than we'd like to use eventually, and I hear that these sensors HURT a LOT when putting in.  If we eventually get approved for our own CGMS, the Dexcom 7, those sensors are way smaller and don't hurt nearly as much to insert.

After the trial period, then Dr.H will have to write a prescription for the Dexcom 7 and sensors.  I'm not sure how much our out of pocket expense would be.  The Dexcom 7 itself costs around $1200 and a box of 4 sensors that last 1 week each is around $425.  So it's pretty expensive.  BUT--if we can get tight control over blood sugar levels to lessen the problems associated with high blood sugar in the long run, it would be worth every single penny spent!!!

http://dexcom.com/products/plus_components

Then Dexcom will have us fill out a ton of paperwork, including a 30 day log of blood sugars.  They would be looking for at least 3 BG's under 50.  The CDE told us that it looks even better to the insurance company to have one of those be in the middle of the night.  We've only had 1 low like that in the last few weeks.  I'm not sure how I feel about that part of the deal.  Do you pray your child has a low that you don't catch?  Do you fudge numbers (dishonest)?  Do you submit what you have and pray that the insurance company approves the request anyway?

Elizabeth has increasingly had trouble being aware of her lows.  Even in the 50's.  And that day that she was 41 during softball.  She had no idea and was as surprised as I was to see it on the meter.  That really scares me and it would be one of the HUGE advantages to having a CGMS!  You can set it to alarm (loudly) if the reading is under a certain level so that you have time to react and treat a low.  I like that.  I might be able to get a little bit more sleep at night.  ;-)

Hopefully this will work out.  If it does, it probably won't be until at least the middle of July after all the hoop jumping and rig-a-ma-roll that we'd have to go through.  But in the end it would be worth it for her to have a little more freedom and security.  :-)

Scary softball game

We have 6 kids and 5 of them play in Little League at 3 different levels. One of us, my husband or I, always have to accompany my oldest daughter, Liz, to her practices & games. Then we figure out what to do for everyone elses games. Some times we're lucky and they're in the same town and we can trade. I don't like missing the little guys either!


Tonight was my chance to watch Elizabeth's softball game.

I love watching her play. I'd never learned the rules of softball until I had a kid playing softball. This is her first year since she was on a t-ball team 7 years ago! She is having so much fun and I am having so much fun. :-) It's tricky for me though, as to what is the best things to do in order that her blood sugar levels stay at a safe level for her during play.

We have been doing fairly well with balance her meal at a decent time before practice / game with pump settings, etc and she hasn't had any lows while in a game. She's had a few highs and even one that involved ketones, but that was from a site failure.

Tonight though, we had our first LOW during a game. Thankfully they had just came back to the dugout to get ready to go on the field. It had been an hour since she had checked her blood sugar (221) and I always have her check each hour. It wasn't until she sat down to check that she started feeling low. She was 41! She had dropped from 221 to 41 in one hour. wow. She was sweating profusely and pale. Her assistant coach said that she seemed to be ignoring her on the field when he was talking to her, which is totally out of character. He kept saying that he should have seen it, he should have known. But ya know...I miss them myself and I'm with her pretty much 24 / 7. It's scary to me that she didn't feel it until she had stopped the activity and sat down to rest. And by then it was a bad low. We filled her full of carbs and within an hour she was feeling great and 134. 2 hours after that though, she said those words I so hate to hear..."Mom, I feel low". She was 60, so not too bad, but low. I'm always ready for more lows after a bad one like that, so her pump was turned WAY down.

Well, not too exciting for a blog post, but it frazzled my evening and I'll be checking on her tonight for sure! Like I don't every night, right??? ;-)

This is also why I want one of these:

New Pump

We got Elizabeth hooked up to her new pump tonight. Her original pump malfunctioned over the weekend. I called Animas (the manufacturer) and talked to a tech who said it would be safest to take her off of the pump until the replacement could get here.

What a roller coaster weekend we had with that! I had forgotten how to do a lot of the calculations on my own (we rely on the pump!). I had forgotten that when you're out and about, any time you need to give insulin, you have to stop the car and your travels, lol. We had forgotten a lot of things while realizes how much we'd grown to depend on her insulin pump. And how much we've taken her pump for granted.

We saw her endocrinologist on Monday and her a1c is down from last fall. October of 2010 her a1c was 8.1. January 31st, 2011 it was 8.4 (her blood sugar had been really high due to a huge growth spurt and hormones and we were having a hard time keeping up with all of that). But Monday, March 7th (just 6 weeks after her last a1c) it was down to 7.8!!! :-)

She was so excited to get home and get back on her pump. I feel much more comfortable with her on it too. Much easier to control her numbers (if you can do such a thing) and also a lot easier to know exactly what's going on with her body. Her pump and me, together we make a darn good pancreas! ;-)

Will she outgrow it...

or get rid of it if she loses weight?

Um...no!

If I had a *penny* for every time I have heard either of those two questions I'd be a rich woman.

There are 2 *main* types of diabetes; Type 1 and Type 2. There are other types, but these are the two main ones that the majority of people think of when they hear the word diabetes. Actually, most people think of Type 2 (or Adult Onset) which is why we get the two above questions.

Every 24 hours in the United States, there are 4230 people diagnosed with diabetes. Roughly 40 of those are Type 1, or less than 1%!

The American Diabetes Association has this to say about Type 2 diabetes:

In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells.


In contrast, they say this about Type 1 (juvenile onset) diabetes:

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar (glucose), starches and other food into energy needed for daily life.

**********************************************************************************************

Insulin is REQUIRED for life. In Type 2 diabetes, the pancreas still produces insulin, but either the body is not able to use it, the body is resistant to it, or the pancreas does not produce *enough* insulin, so the glucose levels remain high in the blood stream. Diet & exercise are both able to control Type 2 diabetes to a great extent. Some times people have to go on oral medications that allow the body to use the insulin it produces. Sometimes, when not enough insulin is produced or the body is resistant to insulin, injections need to be given. In the majority of cases, weight loss alone CAN reverse the disease.

In Type 1 diabetes, because of an auto-immune reaction (I'll discuss the auto-immune process in a later blog entry), the pancreas no longer produces insulin at all. None. With no insulin at all, life ceases to exist. The amount of time for death to occur once the pancreas no longer produces any insulin at all varies from a few hours to a few days. But death is inevitable. The only thing that can buy a person time with the absence of insulin would be a diet with ZERO carbohydrates (no sugar, vegetables, grains). A diet such as this, in and of itself, would eventually lead to death through starvation.

I am very thankful for synthetic insulin because without it my daughter would be dead. Insulin is NOT a cure, it is life support. Her pancreas is still broken. She will always have Type 1 diabetes. But synthetic insulin keeps her alive daily and for that I am very, very grateful.

Start at the very beginning...

that's a very good place to start.

December 10, 2008

I was about 14 weeks pregnant with our 6th baby. I had had blood sugar issues in a previous pregnancy so I wanted to start monitoring my blood sugar levels early on this time around. I got my meter out and checked myself and decided that the next day I would check all of the kids too. We have a family history of Type 1 diabetes, so it (having a diabetic child) was always in the back of my mind as a possibility. So every once in a while, maybe once a year, I'd check the kids. I decided to make the next day THAT day.

We got up the next morning (December 10, 2008) and went about our morning as usual. Breakfast, school work, fun. Then we had lunch. 2 hours after lunch is when I decided to bring out the meter and poker and check the kids blood sugar. NO ONE wanted to do it, lol. The poker scared them, and I don't blame them. But this is something I was insisting that we do. Finally I got the kids lined up youngest to oldest. I figured if the littles could do this without screaming, then surely the older two would be great at it. Wrong.

Thing 5 went first and she did great and her number was perfect. Thing 4 was next and he did great and his number was perfect. Thing 3 went and same as the above. Thing 2's turn. He did not do great. He started screaming and crying and doing everything humanly possible to get out of this. Even though he had just seen 3 littler kids do this without a tear and he was a big 8 1/2 year old boy. Finally I got the drama to settle a bit and I poked his finger. His blood sugar was fine.

Thing 1 was last. She was really hesitant but just wanted to get it over and done with. So I poked her finger and brought that little drop closer to the end of the strip that would suck it up and tell me how much sugar was in her blood.

Normal blood sugar 2 hours after a meal should be LESS than 140.

Thing 1's blood sugar was 539. I panicked, but remained calm enough to tell her to hurridly wash her hands with soap and water. She came back and we went through this again. I was hoping beyond all hope that she had had the remnants of pancake syrup or had dipped her hands in kool-aid or something. Anything that would have meant that 539 was a completely false reading.

I poked her finger and brought that tiny, life changing drop of blood to the end of the strip. We waited 5 seconds that seemed like an eternity. 527.

I dropped everything and went for the phone. I called the nurse at our pediatrician's office and told her what was going on. She said to bring Thing 1 in in the morning for a fasting BS test. I half laughed, half cried and told her NO, she needs to be seen NOW. So we made an appointment for 4:30 that afternoon. I hung up. And I called my mother.

Daddy answered the phone and all I said was "Hi daddy, I need to talk to mom". He handed her the phone. I asked her if using strips that were expired by 2 months would have given a discrepancy in readings. She said probably not and asked me why. So I started bawling (remember too that I was dealing with pregnancy hormones) while I told her the story of the last half hour. The first thing she said to me was, "honey, don't panic". And I cried some more.

You see, my little sister was diagnosed with Type 1 diabetes when she was 5 years old. I KNEW what this would mean for my daughter. My mother KNEW what this would mean for my daughter. I have never asked her, but I bet that after we hung up the phone, my mom probably cried too.

So we loaded the kids up in the suburban and headed to WW. On the way we stopped at a pharmacy and bought a small vial of brand new strips and I retested her. 411. So it wasn't the strips. This was really happening.

We got to the doctor and the nurse used the same type of meter that we had and in the office Thing 1's blood sugar was 416. So at that moment, they were confirming what I had known for a few hours. My first born child, my eldest daughter, had Type 1 diabetes.

A few more blood tests also confirmed. Her Hba1c was 9.9%. The lab's blood glucose reading was 516.

We needed to be transferred to a children's hospital and we had 2 choices. Spokane, WA or Portland, OR. Both were at least 4 hours from home and she would have to go every 3 months for the rest of her life. There are no endocrinologists where we live. We chose Portland because we have family close by.

We got to the hospital at 1:30 in the morning and were checked in just a short time later. And that is where the "fun" began. I'll save that for another day. Time to go check on my daughter.

blood sugar is still high at 329, but no ketones! yay! I also did a temp basal to raise her basal by 10% over the next 4 hours. I've not tried that before, but hopefully it helps. I really need to get some sleep as we're supposed to have a big day tomorrow.

Good night & God bless--
D's Night Time Angel