Pump Anniversary

Seven years ago, my daughter’s HbA1c was 8.9%.

She was three-years-old, had been diagnosed with Type 1 Diabetes for about 14 months…and I had been guessing her insulin dosages pretty much the entire time.

Now, don’t get me wrong. I was doing the calculations, and TRYING to administer the correct dose, but she often needed less than a quarter unit of insulin. Since the syringes didn’t offer anything less than a half-unit marking, it seemed that every dose was a smidge too much or too little. It was a constant guessing game and I rarely knew for sure that she was receiving the actual amount of insulin she needed.

I sat in the office chair that day and cried. I felt defeated and overwhelmed, and couldn’t fathom how I would ever manage to bring her A1c down safely. My daughter had a history of severe symptomatic hypoglycemia, and I was petrified to increase the amount of insulin she was using. Our endocrinologist had been gently encouraging the transition to an insulin pump, but the notion of such a significant change left me paralyzed with fear.

I went home, sat down, and began scouring the internet for help. It was the first time I had ever turned to the online community, and I wasn’t sure how online forums worked. I worried that people would use my admission of her A1c as a way to measure me as a mother. Even still, I summoned the courage, and made my first post: “We went to the endo today. My daughter’s A1c is 8.9%, and I don’t know what to do.”

Then I sat back and waited for the flurry of judgment to begin.

Except that’s not what happened. Instead, I learned I wasn’t alone. I learned that other people shared the same fears and frustrations. I learned that there were parents who had been dealing with their child’s diagnosis longer than me who still felt overwhelmed at times. I learned that there were other very loving, devoted parents who had children with an A1c of 8.9% (and higher). I learned that an A1c didn’t have the power I thought it had.

I read every forum I could find. I searched for articles and personal accounts of successful A1c reductions. I went from feeling completely discouraged to completely encouraged …and then a funny thing happened:  I began to feel empowered. I felt capable of turning the situation around, so I formulated a plan and called our endocrinologist to discuss it with her.

Together we decided to make three changes:

1) Bolus all meals and snacks before eating instead of after. (She was a picky 3-year-old, and often didn’t finish all of her food. We learned to rely on alternatives such as yogurt and applesauce to replace the carbs she didn’t eat.)

2) Monitor glucose levels every night at midnight, and correct for high blood sugars above target range. Recheck during the night as needed to monitor for hypoglycemia.

3)  Transition to an insulin pump to allow for micro-dosing.

There it was…in the open. It was time to make the jump from shots to a pump so we could start measuring her insulin more precisely.

And we did. Our transition is an entirely different story, but coming to the realization that an insulin pump would be the best option for her management was a journey in itself.

PS – I’m pleased to report our plan worked!

 PSS -- Puberty is just around the corner {shudder, shudder, shudder}. From what I hear, that’s an entirely new ballgame. Someone hold me.