Hba1c not coming down !!

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stella

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hi everyone just need some advice please
My daughter is 14 and her hba1c has been as follows, 14 % in June 10% in September and now 12% this month, her levels during the day vary between 4 & 9 but mostly in range , however she wakes up over 16 most mornings even though she's on 44 units of levimere a night !! We're under the watch of social services as the hospital accused us of neglect because her a1c was so high. Ss want to close the case as there is no evidence of our neglect, the hospital even went as far as saying her "good" readings are not her own and have been falsified (using my blood) because her a1c doesn't reflect that. So my question is , her high readings overnight are obviously a big part in her high a1c but how do I keep them down overnight? (she goes to bed at around 5-6) I'm really getting so frustrated at being accused of neglect when it's not the case, how can I control her overnight readings?? I've even woke up early hours to test and correct her but it has made no difference!!
 
Sorry to hear you are still going through this. High morning readings will affect the HBA1C result.
 
One thing that occurred to me was that whilst your fighter may be more in range pre meal I wonder whether she is eating foods that make her spike and are quick acting carbohydrates. Has she considered reducing the amount of carbs at meals, or eating foods that release more slowly?
 
Could the Levemir be split thus making it easier to adjust? Has your daughter been fitted with a sensor so the team can see what is happening to her blood sugars?.
 
Could it be that her Levemir isn't the problem but her evening meal is? If the ratio on the evening meal isn't right for my son that throws the whole overnight off. He's definitely slower digesting at that time of day too so we have moved to bolusing after he's eaten rather than before. And there are definitely foods we avoid after 5pm.

Have you done a basal test recently? When does the rise start?
 
That is very bad getting accused of lack of care. BG is hard work to keep right. The hosp does not seem to be helping or is it a nurse ? :(. Good luck 🙂
 
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