Percentage within range?

[MeanMom]

Just spent the morning doing some sums and graphs partly because of K's 1st annual review tomorrow, and partly because I wanted to try and get to the bottom of what I have been feeling lately were out off control levels, and see if there was a pattern or something.
I have worked out that over the last 40 days K has only had 36 tests under 7 (out of her 160 'scheduled' tests have not included tests for hypos etc). This is less than 25%. She has however had 93 tests under 10 (58%) but that still means over 40% of the time her tests are over 10.
I was thinking about how I could fix this (change ratios, split her levimir, panic?) and that her HBA1c was bound to be worse than her last one, and thought I would have a quick look through the previous 40 days (which included Christmas and her last HbA1c was done just at the end of it) The last 40 days were even worse😱 only 25 tests under 7!
Does this mean her HbA1c will be lower this time? Answers on a postcard please🙄

 

[Northerner]

Hard to tell. What I would say is that the numbers aren't as bad as they might seem - if 129/160 tests are in single figures for a growing child then I think that is pretty good going. I'm sure other parents will be able to give you a better idea of how good this is. I think children are expected to generally run higher than adults. Looking at my stats since I first got my meter software in August 2008, I have 63.8% in range (3365 tests!), 24.2% above range (1274) and 6.5% below range (632). For the past two weeks my inrange figure has improved to 76.8% in range, so as time has gone on I have clearly improved my control.

 

[novorapidboi26]

I would roughly estimate, well, there is a formula, that an average BG(90 days) of 8.5 mmol/l should give you round about a 7% HbA1c.

Your doing a great job............

 

[bev]

Hi MeanMom,

I wouldnt focus too much on the HBA1C at the moment. If you are seeing that levels are gradually creeping up then perhaps ask your team for advice on how to change things. Are there any patterns of high's that you have noticed. What regime is K on. Have you ever used a CGM from the hospital - this would give you some good data to work on.🙂Bev

 

[MeanMom]

Hi MeanMom,

I wouldnt focus too much on the HBA1C at the moment. If you are seeing that levels are gradually creeping up then perhaps ask your team for advice on how to change things. Are there any patterns of high's that you have noticed. What regime is K on. Have you ever used a CGM from the hospital - this would give you some good data to work on.🙂Bev

Thanks everyone - Bev that was why I was doing my graphs to see if I could see a pattern to discuss options with team tomorrow. Couldnt see a pattern other than it proved to me what i already knew that we need to do something to get her lunch time reading down at it is above seven 90% of the time.

As I said I also realised that wheras I thought things were getting worse they are about the same or slightly better🙂 And as K is feeling better in herself I s'pose I shouldnt worry to much about numbers. (Any guesses for the Hb.....?)

 

[Robster65]

Does her meter tell you the 30 or 60 day average ?

You can get a rough idea from that. Everydayupsandsowns has a formula to work it out.

Rob

 

[Adrienne]

Hiya

I wouldn't dwell on the under 7 at all. You are talking about a growing child so only look at data between 4 and 10.

It is very hard to see what is going on inbetween all the tests and this is where people get higher HbA1cs as they don't know what's happening inbetween sometimes.

A CGMS would be a big bonus to you, even to use one for a week to see what is happening.

Before pumping we used a CGMS twice (this was before Lantus / Levemir as well) and it showed both times there were hypos overnight inbetween night time my testing.

If all kids were given the same technology it is amazing what can be achieved. Jessica is a prime example of very hard to manage diabetes, she has no pancreas so there are issues which make blood sugar levels very hard to manage. However we have an up to date pump with sensors (CGMS) which are fully funded. I have been tried to download a photo of the latest graph for all those sensor doubters out there just to prove they are worth their weight in gold.

Jessica sensor was 81% in range last week, they are generally 75% in range but we had a pump upgrade a week and a half ago and the sensors respond better to the newer pump. From lots of testing and new alerts and alarms I was able to keep the majority of numbers in range. I know that the data from the sensor was true data as well and that the results match blood sugar finger pricks as I carefully monitored it last week. So given the right tools, which I why I bang on so much about pumps especially for kids, you can achieve very very good results which will set up the children for a good and healthy as possible future.

Once I can work out how to get the graph uploaded as it is too big I'll post it.

Bev is right about the HbA1c. A very inspirational man does a talk on this entitled 'Its not just a numbers game' and makes a huge amount of sense.

So only think of 4 to 10 for the time being. 10 being after a meal preferrably. Being 7 before lunch is not a bad thing, it could be worse. Do you have the post breakfast spike? If not and it is fairly stable then there is not much more you could do. If you get the post breakfast spike and you try to sort that out, you run the risk of many hypos by lunch time. Lots of us have got that t-shirt unfortunately.

I think you are going fantastically by the sounds of it with the tools you have been given. 🙂

 

[MeanMom]

So only think of 4 to 10 for the time being. 10 being after a meal preferrably. Being 7 before lunch is not a bad thing, it could be worse. Do you have the post breakfast spike? If not and it is fairly stable then there is not much more you could do. If you get the post breakfast spike and you try to sort that out, you run the risk of many hypos by lunch time. Lots of us have got that t-shirt unfortunately.

I think you are going fantastically by the sounds of it with the tools you have been given. 🙂

Thx - just gone back over my (very preety) graphs and the numbers for lunch time are around 50% over 10 (and as I said 90% over 7). I think K does get a mid morning spike but at the moment I have no ay of proving this or doing anything about it K does not have the time or the inclination to test mid morning when she is at school and her figures for non school days are much different as she is rarely out of bed before mid morning!)

I have been thinking of the CGM but would imagine her team wouldnt be willing to fund it as her control is Ok as far as they are concerned

 

[bev]

Thx - just gone back over my (very preety) graphs and the numbers for lunch time are around 50% over 10 (and as I said 90% over 7). I think K does get a mid morning spike but at the moment I have no ay of proving this or doing anything about it K does not have the time or the inclination to test mid morning when she is at school and her figures for non school days are much different as she is rarely out of bed before mid morning!)

I have been thinking of the CGM but would imagine her team wouldnt be willing to fund it as her control is Ok as far as they are concerned

Hi MeanMom,

Does K have to go to the Medical Room to test. Alex just tests wherever he wants to and does it during lesson - so doesnt have to leave the classroom - unless he is high and needs advice. I am just wondering whether this is the reason K doesnt test - it is a nuisance for them if they have to keep going to the Medical Room isnt it.🙂Bev