The Importance of The Hemoglobin A1c Test

Earlier today, my daughter paid a visit to her Diabetes Management Team for a checkup.  We emailed her Nurse Practitioner the latest diabetes spreadsheet that I put together.  It's a very simple chart that keeps track of daily blood glucose levels, carbs per meal, insulin doses and any exercise that she may have done each day.

As part of her routine diabetes checkup, she has to undergo a hemoglobin A1C test (also called HbA1c, glycated hemoglobin test, or glycohemoglobin) which provides an average of your blood sugar control over a six to 12 week period.  This test, combined with consistent home gblood glucose monitoring will provide you and your child's team with a clear picture of how well their blood glucose is being controlled. 

I've already stressed the importance of tracking and maintaining precise records of your child's pertinent diabetes information.  Now, I am going to stress the importance of going to regularly scheduled doctor appointments and taking the a1c test.  According to the American Diabetes Association, "People with diabetes should have this test every three months to determine whether their blood sugars have reached the target level of control. Those who have their diabetes under good control may be able to wait longer between the blood tests, but experts recommend checking at least 2 times a year."  The normal range for the hemoglobin A1c test for people without diabetes is between 4% and 6%. The goal for people with diabetes is an hemoglobin A1c 7% or less.

The higher the A1c percentage, the higher the risks of developing complications related to diabetes.  Keep good records and get the a1C checked regularly.  It's critical in keeping your child healthy!

(BTW....my daughter's a1c result was 7%.)

Type 1 Diabetes - Walk for the Cure Fundraiser

I know that it is short notice, but I have just registered ‘Team Sofia’ with the Juvenile Diabetes Research Foundation’s (JDRF) Walk to Cure Diabetes Fundraiser.  The event information is as follows:

• Date:  October 23, 2011
• Walk Location:  Cook Campus, Rutgers University
• Registration Start Time:  9:00 AM
• Walk Start Time:  10:00 AM
• Length of Walk:  4.5/5 miles

The JDRF Walk is a fantastic way to make a difference in the millions of lives of people affected by type 1 diabetes. For at least that one day, they will look around and see all the support they have from their friends, family and community.  On Walk Day, everyone can have fun and celebrate how much closer to a cure we are because of their efforts. If you have taken time to visit our team page today, please consider making a donation and/or joining the team.

 

To join and/or to donate to Team Sofia, click the team link (or copy and paste into URL address field if clicking doesn’t work) below:

 

http://www2.jdrf.org/site/TR/Walk-NJ/Chapter-MidJersey4400?team_id=36795&pg=team&fr_id=1496

 

Thank you. Together, we will cure type 1 diabetes and its complications!

Controlling Blood Sugar Through Portion Control

Last week, I read about how Bob Krause has managed to survive 85 years with Type 1 Diabetes.  A tremendous feat considering the decades of employing archaic methods of tracking blood glucose and administration of inconsistent insulin quality.  It struck me how methodical Krause was about what and when he ate and drank.  To paraphrase what he stated in the article, Krause mentioned that he only ate enough food that his body needed.  His diet consists of a bowl of nuts in the morning and a salad in the evening.

At the time, my daughter's BG levels had gone from a state of tight control to a bit out of control.  Talking to her diabetes team, we tweaked her carb : insulin ratios and were able to bring it back to a much better place.  I still wasn't fully satisfied because there were a few high readings that were making me uncomfortable.

Looking over her records, I noticed that each meal was between 40 - 50 grams of carbs and the meals were larger than I thought she needed.  I decided to bring the carb intake down to 20 - 30 grams of carbs per meal and shrink the portions down a bit to decrease calories.  Sure enough, her BG levels dropped but may have dropped a bit too low (particularly overnight).  Right now, I am experimenting with staying on this plan, but supplementing with some strategically timed 10-15 grams of insulin free snacks to maintain a healthy BG level.

So many things can affect BG levels, including diet, exercise, sleep, stress, etc.  Don't be afraid to (under your doctor/nurse supervision) experiment with different approaches to maintaining healthy BG levels.

Flu Shots - A Necessity for Diabetics

Diabetes puts you at a higher risk of getting the flu. When blood sugar levels are high, immune cells do not work as efficiently. Studies show that diabetics are sick with the flu for longer periods of time and have a higher probability of being hospitalized.  Additionally, once someone becomes sick with the flu, it's much more difficult to control blood sugar levels.  Getting a flu shot when you have diabetes, can prevent or minimize these risks.

The Center for Disease Control (CDC) recommends that people get their seasonal flu vaccine as soon as it becomes available in their community. Get yourself and children (ages 6 months or older) vaccinated before December to ensure that protective antibodies are in place before flu activity is at its highest. Flu vaccine shipments began in August and will continue throughout September and October until all vaccine is distributed.

Contact your doctor or nurse about getting the flu vaccine as there are some individuals that should not get the vaccine.  Also, in order to be prepared for flu season, you should also have a sick day plan made with your child's diabetes health care team.  Follow this link to view the CDC flu brochure for  diabetics:  http://www.cdc.gov/diabetes/projects/pdfs/eng_brochure.pdf

Keep Track and Know Your Child's Numbers

Although keeping track of your child's blood glucose numbers may seem daunting (especially upon  diagnosis), technology has made it a lot easier and more reliable than ever before.  Bob Krause, who has been insulin-dependent for over 85 years had to boil his urine in a test tube and mix it with a soluble tablet.  The urine would turn a different color depending on how much sugar was present.  This was the most common method of blood sugar testing until the early 80's.  Since then, blood glucose meters have been the fastest and most accurate means of testing.  Glucometer technology has also come a long way as smaller blood samples are needed while providing results in seconds.

Where am I going with this?  Checking and keeping track of blood sugar levels is the greatest tool that diabetics have in making sure that they are keeping healthy.  The more often you check, the more likely you are to stay within the normal blood sugar range.  Along with glucometers, there are a number of software applications available to diabetics and parents of diabetics that will allow you to input BG numbers, carbs, insulin dosages, etc., so that you and/or a healthcare professional can track trends in BG levels.  Diabetes apps continue to pop up all over iTunes, Android Market, or via cloud technologies.  I've created a simple Excel spreadsheet that allows me to monitor my daughter's pertinent diabetes stats and run different reports to present to her diabetes management team.

Whichever method works for you and you family, be diligent about staying on top of tracking.  It can not only add years to life expectancy, but also improve quality of life. 

 Click here to an article that mentions some of the available apps.  Feel free to contact me, if you want a copy of my Excel spreadsheet. (It's free.)

Educating Those Around You

Diabetes was not a disease that I ever paid close to attention to prior to my daughter's diagnosis.  Frankly, when thinking of diabetes, I thought of it in terms of the more common Type 2.  After my daughter's diagnosis, I came to the realization that I hadn't been the only one as most people approached me with similar misconceptions. Common questions include:

• "She's so thin, how did she get it?"
• "Did you feed her a lot of sugary foods?"
• "It goes away over time right?

In a nutshell, here is a quick and easy explanation of Type 1 Diabetes that can and should be shared with others:

Type 1 diabetes can occur at any age, but is usually diagnosed in children and young adults.  Although the exact cause of type 1 diabetes is unknown, it is generally thought to be an autoimmune disorder. An infection or some other trigger causes the body to mistakenly attack the cells in the pancreas that make insulin.

It is most often diagnosed in children, adolescents, or young adults.  Insulin is a hormone produced by beta cells found in the pancreas.  Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin. Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. It's why there is the need for type 1 diabetics to inject insulin and not take a pill.

Blood Glucose Readings can be a Rollercoaster

Last night, we checked our daughter's blood glucose level and found it to be a super high 400.  Sometimes it seems that there is no rhyme or reason to why it happens.  Her dinner had been a little higher in carbohydrates than usual, but we had it covered with the recommended dosage of Novolog.

Upon discovering the reading, we immediately called the endocrinologist that was on-call to seek advice for next steps.  We were told to wait it out as it should lower by the morning.  She woke up today at 75.  Always keep the phone number to your child's endo team on hand as you never know when you'll need it.