Thursday, December 27, 2012

ENDO Checkup #10

Oh my goodness, I have been so delinquent in my blogging!  This post is long overdue since Natalie's checkup was in November, so I wanted to post it before the year was over.  This was Natalie's first checkup that included her wearing her Omnipod insulin pump for the full three months.  I didn't really know what to expect since she had quite a few highs with the start of the pod and getting her basals and ratios all worked out.  I am happy to report that her A1C did not change too much from her prior checkup and was 7.4%.  (A1C of 7.2% in August after being on the pod for 2 weeks.)  Her Dr. is happy with an A1C of 8% or less for a child her age.  When I say that her A1C is where it is supposed to be for her though, it does not mean that is the norm for someone WITHOUT T1D.  A person without T1D generally should have an A1C between 4-6%.  The reason a child with T1D should have an A1C higher than that is because of the risk of too many low blood sugars.  An A1C of 7.4% means her average blood sugars for the last 3 months was around 166.  An A1C of 6% would mean an average blood sugar of 126. 

The average on her PDM (wireless device that programs how much insulin her pod is to deliver) showed an average blood sugar of 173 for the last 3 months, so pretty close.  I love the detailed averages that the PDM tracks.  It also showed that her high bg for the last 3 months was "High" meaning too high to calculate and a low of 42 (scary low!).  It showed that her little fingers had been pricked over 1,070 times in the last 90 days.

As usual, she grew a lot which can attribute to some of the high blood sugars we might have seen in the middle of the night.  (Growth hormones peak in the night.)  He checked her thyroid for signs of any problems (which she giggles uncontrollably because it tickles) and her legs and arms for signs of lipohypertrophy (build up of tissue from repetitive insulin shots which can cause the insulin to not be absorbed in that area).  She still has a bit of a bump on her thighs, but the insulin still absorbs great there.  He said her bottom and thighs are the only area for her to wear the pod for now, because her arms are too skinny to hold the weight of the pod and her tummy has nothing to pinch.  That was disappointing to hear because she did get shots in her arms and she has wanted to try a pod there.  I hate to miss the opportunity to try a new spot when she is so willing. 

I also asked him about some of her lab results from May.  Her Total Cholesterol seemed a little high to me at 178, but he said it was okay since it was not a fasting test.  Her HDL was great and her Triglycerides were okay.  T1D affects EVERYTHING and the possibility of any complication scares me. 

When her Dr. greeted us he said "I was excited to see you on my schedule for the day because I know you are more up to date on the latest technological advances than my average patient."  He had recently attended a technology conference where they reported that the human clinical trials for the closed loop insulin pump (artificial pancreas) will be available for children shortly.  He was very optimistic about the trials and the possibility that the closed loop insulin pump will be on the market in the next couple of years.  That was a boost to my confidence that he recognized and appreciated that I keep up to date with the latest research and advances.

Speaking of the artificial pancreas, I had the opportunity to meet someone who is participating in the clinical trial at the University of Virginia (UVA).  I was able to hold and push the buttons on the "artificial pancreas" which is actually a cell phone that is used to input the carbs and also tracks the blood sugars and alerts when the blood sugar gets too low or too high and is able to adjust and correct on its own.  He was wearing an omnipod, but would have to use another insulin pump for the trial.  Currently the omnipod does not have blue tooth capabilities so would not be an option with the artificial pancreas.  It also requires that the person have 2 sites on their body (one for the continuous glucose monitor and the other for the insulin pump).  It is exciting that it would be able to stop administering insulin if dropping too low, but something I would probably look more into when Natalie is older.  The local news station did a report on the trial and next thing I knew they were hooking me up to a microphone and asking my opinion!  Here is the link if you missed it when I posted it on facebook.  I was still getting over not having a voice for 2 weeks, so I sound a little raspy.  It is very exciting to live so close to where all the action is taking place!  I learned that UVA directs the trials for ALL the Artificial Pancreas trials all over the world, not just the U.S!   

Trials Underway for Artificial Pancreas

I have lots of unfinished blog posts in my draft folder that I am determined to get out in the next month so stay tuned!


  1. This is definitely not medical advice, super skinny 8yo (wearing OmniPod since 5yo) gets her best absorption from wearing her pod on her tummy and the back of her arms. Her favorite spot for both her CGM (again, not medical advice) and her pod is her arms.

    1. Thankks Leighann, I have noticed other young and skinny ones that wear their pod on their arms and tummy. Even the nurse practitioner we see every other time said no though?? I am afraid to try and it really hurt her. We definitely aren't ready for the tummy, because she won't let me near there, but maybe we can try arm in a few months. Not much space on these little girls!

  2. I agree with five year old daughter wears them on her tiny, muscular arms and loves it. If she wears a band from Bands4Life, she has no issues with it on her arms and even makes it through two gymnastics practices a week. She won't wear it on her tummy but we also use her lower back and bottom. Hopefully, the new, smaller pods will work better on our little ones!

  3. Bravo on another great A1C...It is always hard for me to hear the a1c's of Isaac knowing what a non-d person's are, I think we like to strive for that for sure. But, you're doing great :) And if you ever need another boost to take away the fears about complications, look at my husband he's had t1 for over 20 yrs, no complications and was never as focused on management (as a child) as we are today. His first few years of insulin was regular, where it had duel peaks and he had to eat at certain times only a certain amount of food - but still he strived, played sports, did well in classes, was very social. These little things sometimes help me in knowing that our kiddos will be fine, they will strive, they will be amazing adults :) Have a lovely holiday break!