A1c Sauce

Every time I hear "A1c" in recent weeks, it makes me think of Caleb from "This is Caleb"  Caleb's mom, Lorraine, posted a video of Caleb on her blog and he told this joke (I'm paraphrasing here...)

"What does a person with diabetes put on his steak?"

"A1c Sauce!"

I think that's hilarious!  Apparently, I'm down with 7 year old humor!  I find it to be a refreshing change from 5 year old humor - which is really just saying 'underpants' and then laughing hysterically.

Speaking of A1c.....

Back in the fall, we went to our quarterly Endo appointment. 

We were pleasantly surprised with an A1c of 7.5.  Sweetpea has been steadily decreasing since dx.  Here are our A1c results:

April 2009 - Diagnosis:  12.5

May 2009 - 10.2

August 2009 - 8.5

November 2009 - 7.9

March 2010 - 8.0

June 2010 - 7.6

September 2010 - 7.5

It was also time for her yearly blood draw (aka arm draw..... aka extreme horribleness).  I decided that even though her Celiac screen was normal last year that we would go ahead and add it to the panel.  Just to be safe.  I wouldn't worry so much if it wasn't for the MAJOR constipation issues she has.  Issues that started at the same time that D entered our lives.  And yes, I know that Celiac is usually linked to diarrhea.... but not always.  And why not just go ahead and do it if we're getting blood drawn anyway?

So we did.

It was unfun.  Sweets detests arm draws.  Even though we numbed her up and promised her Chocolate Chip Pancakes after!  But she did pretty well and the nurse was AWESOME so it wasn't as awful as it could have been.

The results came in....  Negative again.  So I feel like I can relax a little about that.  Plus her constipation issues (or poop issues as she calls it) are getting better.  Praise the Lord!

We went back to the Endo in January. 

I was seriously worried about this one.

Part of it was due to the string of highs we had that were associated with the bad sites that landed us in the hospital on World Diabetes Day.  I couldn't help but wonder what all those bad sites and high bg's had done to her A1c. 

I was a bit obsessed.  I remember being IN THE HOSPITAL and thinking, "Well, Hell.  There goes the A1c." 

I was checking our averages rather often.

It was not pretty.

But.... as the saying goes.... one high number does not an A1c make.

And her A1c in January was.......   7.1%

WOOT!

I was thrilled! 

Until.....

Our wonderful Endo is out on maternity leave.  *sob*  So we had to meet with a different person this time.  And she totally stole my A1c joy.

She thought that her A1c was too low. 

She thought that Sweets had been having too many lows.  And that "anything under 8.0% is considered good for her age so 7.1 is a little low."

Hmph.

So I immediately began to worry that I was depriving my growing child of the sugar she needs to function and grow.  I pictured her little brain gasping and struggling to function.  It was sad.

Reyna over at Beta Buddies posted this chart on her blog today:

The American Diabetes Association has the following A1C recommendations for children and adolescents with diabetes:

Children younger than 6 years old - 7.5% to 8.5%
Children ages 6–12 years old - Less than 8%
Teens ages 13–19 years old - Less than 7.5%

So....  I suppose it IS a bit low.

However, an A1c of 7.1% is approximately equal to an average blood glucose of 176.  Sweetpea's target blood glucose is 150.  So it's a bit confusing.  How can an A1c that correlates to a bg level that is 26 points HIGHER than her target be too low?

I realize that a higher A1c that is achieved with less ups and downs shows better control than a lower A1c that is achieved through multiple lows.

And I do recognize the need to reduce the number of lows. 

As I see it, it's a work in progress.  Getting the Dexcom allowed us to be more aggressive.  Being more aggressive means (for us) prebolusing meals, making more changes on our own, and running her lower at night (being comfortable with a number between 100-150 instead of preferring a number between 150-200).  Inevitably, this leads to lows as you are figuring out the perfect balance. 

I also recognize the need for ME to be ok with how we are handling her care. 

I need to be ok with these numbers regardless of what a doctor or a chart tells me. 

And I am.  I know that we are doing everything we possibly can to manage her diabetes and tighten our control.  God knows, we're not perfect.  But we're trying. 

And as long I know we're giving it our all...  I'm ok with whatever number pop up.

Pretty much...!

(I decided to put The Gambler at the top of today's playlist because that's what we do with numbers... it's a gamble.  No matter what.  And then Low Rider... because I thought it was funny!  Will close the play list poll down soon....)