Thursday, June 17, 2010

A1C for effort

Tomorrow is Elise's quarterly endo appointment, and I have no idea what to expect, report card-wise. We've had some great numbers over the last three months, but we've had some ugly highs in the past three or so weeks. Lately, Elise has been swinging all over the place.

Over the past two weeks, we've had to decrease her bedtime insulin twice. Now she's getting a whole unit less than before. And it looks like we need to decrease it again. She can go from the mid 300s at bedtime (8:30), to 88 by 1:00 am, after getting only 2.5 units of NPH* and her uncovered snack of 15g. Shouldn't her insulin needs be increasing because she's growing? Bah, I just don't get it.

Thankfully, we can run all this by her endo tomorrow. Fred and I feel pretty confident in handling any changes by ourselves, but it is nice to have the doctor's advice too.

And hopefully, tomorrow's A1C will reflect all the hard work we've put into Elise's care over the last few months.

*It just occurred to me that I write about Elise being on NPH, but not everybody knows what it is:
NPH is an intermediate-acting insulin with a slower onset of action and a longer duration of activity. Sometimes I refer to it as N. In Elise, it usually peaks at around 3 hours, has a second, smaller peak at about 7 hours, and is usually out of her system by 9 hours. Most people hate it, but it works for us. It also means less shots for Elise. If I do use a term you're unfamiliar with, I wrote a post awhile ago called "What Does it all mean, Anyway?" You can find explanations there.


  1. We have been seeing a big decrease in insulin needs as well. Must be something with the summer heat? Who knows! I am tired of adjusting, adjusting, adjusting!

    Can't wait to hear about your appointment!

  2. We've been noticing that Lily seems to need less insulin just before she hits a big growth spurt. Once the growth spurt is over, then we have to increase insulin dosages again. It's a frustrating cycle sometimes. Life is never dull!

  3. I hear about the decrease in insulin needs. A few months ago, she was taking about 10 total units a day (lantus and novolog combined) and now we are some where between 6 and 8 units a day. It can be frustrating because of those lows that can happen. Hang in're doing great and I'm sure that her A1C will be FAB.U.LOUS!!

  4. You know, with my girls I have had both of them go through different periods of needing less insulin and then out of nowhere we have to up it again!

    I'm not sure what that is all about, D still throws us curveballs every now and then.

    Good luck at the Endo's, you guys are doing a wonderful job in caring for Elise!

  5. Oh. My. Word. I thought we were having overnight issues! Matthew isn't dropping nearly that much.

    I'm glad you can run things by the doc. It always helps to get their opinion.

    They had some good ideas for us on the Lantus. We're going to move it up a couple hours, so we'll see....

    Anyway, I hope you have a great appointment tomorrow! Remember, it's just a small part of the big picture. You're staying on top of it and doing great!!!!

  6. Whatever the result, you know you've done all you could. Sounds like you are very level headed about what to expect.

    Insulin needs often go down in summer months because of increased activity. Oddly, Caleb's are up 20%, so who knows?

  7. I have had a decrease in insulin myself I think it could be that in summer we just get out and do more and for some of us our insulin kicks in better in the summer . jUst a theory and my two cents for what it is worth .

  8. I hope your appointment goes well and you all are able to enjoy your day. You and Fred do such a fantastic job with Elise - - - you both inspire me! :)


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