[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance

Re: [IPk] HbA1c backtrack

On 19 Sep 2003 at 10:33, Melissa Ford wrote:

> I've read in the past few years that HbA1c looks back only
> about 6-8 weeks or so, which would make it unlikely there
> would have been pre-diagnosis information in Robert's latest
> result. 

Yes, I've read that too. These are his figures for average 
BG and hypos so far.

Diagnosed 25th March
Average BG    Hypos (<=3.3)
April   5.7           8
May   6.1           1
June  6.0            1       
July   6.1            0
Aug   6.2            1

His HbA1c on diagnosis was 9.0%
8 weeks after diagnosis (around 14th May) it was 7.6%
Just over 5 months after diagnosis it is 5.9%

Looking at the lower average BG and 8 hypos in April I 
would have expected a lower HbA1c at 8 weeks unless it does 
cover longer than 8 weeks. Of course he could have been 
having lots of highs when we weren't doing tests and on 
thinking about it he did spend a week and a half with 
friends in Wales at the beginning of May. It was just over 
a week before the HbA1c so maybe that time had a 
disproportionate affect on the result. I think he let his 
BG's run a bit higher because he was worried about hypos 
and I suspect he was fed well by his friend's parents as 
well! Our clinic still say that the HbA1c represents 12-13 

> Re the rise in HbA1c you've seen with Emily, I wouldn't
> project exactly the same trajectory for Robert--as a nearly
> if not already pubescent boy rather than a prepubescent
> girl, his hormones, food consumption, and activity patterns
> are probably quite different from Emily's. In the next year+
> he may well wind up with HbA1cs higher than Emily's because
> of those, though. Puberty ain't easy :-/ .

My brother was on tablets & diet for around 2 years when he 
was diagnosed at 20 and Emily was on relatively small doses 
by body weight for the first 2-3 years so I am hoping that 
this slow onset pattern is genetic :-) Both Robert and 
Emily have already entered puberty so I'm keeping my 
fingers crossed that Robert has a long honeymoon period to 
help cushion the difficult time over puberty. 

He must still be producing quite a bit of his own insulin 
as he only injects 0.3 units of insulin per kg compared to 
Emily's 1.2 units per kg which I believe is a more normal 
amount in puberty and it is very easy to maintain his 
levels ATM. 

We spotted his diabetes early and despite a Hi reading 
(>33.3 on our meter) when he was diagnosed there were no 
ketones. The only ketone reading he's had was a 0.1 or 0.2 
on the second day. Hopefully there are quite a few Beta 
cells still working away. He had obvious symptoms for an 
afternoon/evening and less obvious symptoms for around a 
week in hindsight. Emily had symptoms for about 4-5 months 
as far as we can recall :-(

> Hearty congrats and best wishes to your whole family,

Thanks! I should have added a big thank you to everyone on 
this list for all the help and information I've gained 
directly and indirectly through reading here. It's helped 
with MDI, our decision to apply for a pump and the wording 
of our pump request letter. INPUT have been a great help 
too, particularly since we decided to go for the pump.

Best wishes,
Mum to Emily aged 11, dx Oct '99
Novorapid x 4, Glargine x 1 - pump requested,
Robert aged 13 dx Mar '03 
Novomix 30 x 2 (+ Novorapid when hungry!), 
and Matthew aged 8.
for HELP or to subscribe/unsubscribe, contact: