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Re: [IPk] paediatrician

Well I do think that A1c of 5.5 may be a lower than what most paediatricians
like for a young child even those who are more dedicated and work in the US
and have more resources than we do here. I dont know what their "normal lab
HbA1c level is either".  When I have read  of type 1s having this low a level
I thought that they must be hypoing all the time but this doesn't seem to to
the case with Sasha (fingers crossed) today because I had to up her insulin
dose today as
she has a cough and her bg was 19mmols yesterday at 11.30 am and I had to go
up to the school.  She is still coughing and is having to take her asthma
puffers which she hasn't had to  for nearly two years.  Also we have been
in the last 6 months no colds coughs or any infections.  When things are going
well she is very stable overnight and has good levels the night is long and
good levels at night greatly effect the HbA1c.  I dont know how long before
there is a cure for D, if ever and I feel doing night checks will give her
years with less problems in the future.  No guarantee of course, but by the
she is 25 and still a very young woman she will have had 20 years of D.  So I
feel I have to do my best and if checking at night is necessary then I, or
husband will do it.  Also the teenage years maybe hard so I also feel that if
I do my best now then it wont be quite so bad when she is taking over her own

I just think that the consultant at our clinic does not have the time to
discuss lots of things with the parents.  He is not a diabetes specialist but
the senior paediatric consultant at our hospital.  Our D nurse is constantly
busy as she deals with all type 2 that come to her. There is just not a long
enough appointment available.  Two of the parents in my support group with
newly diagnosed children toddlers are just in despair at times because they
cant keep hardly any sort of control with very young kids its so hard.  In the
US they tend to put small children on small doses of humalog so that they can
dose for what they  do eat.
Here they seem to struggle on with Mixtard.

If I didnt have internet support I dont know how we would cope.  I suppose I
have got a lot of information from books too.  I happen to see this book in
the clinic and borrowed it, Ragar Hannas, Insulin Dependant Diabetes in
children adolescents and adults.  There is a new addition available in
October.  But if you are just a parent and do not have internet access and
your clinic wouldn't lend you books you may not even know that good books are
available.  They never have any decent one in the normal books shops.

The best thing about our clinic compared to some others that people have told
me about is that if I ask to make a change and say "what do you think if we
tried so and so because this or that seems to be happening" usually I am given
a prescription.
So perhaps I have been lucky there so far.

I may look in to Lantus when it becomes available.

----- Original Message -----
From: "Abigail King" <email @ redacted>
To: <email @ redacted>
Sent: 29 May 2002 16:53
Subject: [IPk] paediatrician

> So An HbA1c below 5 is too low. 7.2 is better. ???!!!. Despite the fact that
> she was having seizures at a higher level?
> Does this guy have any knowledge of DM at all??
> You mentioned other kids at the clinic who are denied sweet things at any
> time. are these the same kids who have high A1cs, who wouldn't and aren't
> encouraged to check BG regularly and wouldn't accept or aren't encouraged to
> have more injections when more = better control?
> Sounds like they are being made prisoners within their own bodies. In a way
> they are being punnished by not having encouragement to optimize control,
> more flexibility with food etc
> This also shows the extent of denial among some of the profession, telling
> people to avoid sweets and everything will be ok, no need to carb count etc
> Outdated knowledge and attitudes!!!
> Some one needs to tell these kids that injections, BG tests are nothing
> compared to other diabetres issues with which they will have to contend
> Jackie
> You have to be congratulated on acheiving such fantastic glycaemic control
> ----------------------------------------------------------
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