Was Freddie using the stool to gain access to the biscuit tin? – by Linda Fox
Regular HbA1c hospital appointments make me anxious as Freddie’s results are high. After first diagnosis he was 78mmol and at his second appointment he was 86mmol which astonished and horrified us in equal measure. How was this possible when insulin was being administered? We had a strict diet in place and regular blood tests with acceptable blood sugar levels which we regularly informed the nursing team of. It was a complete mystery in true Cluedo style.
Was it Freddie in the kitchen using the stool to gain access to the biscuit tin? Or was it the little piece of chocolate cake we gave Freddie as a treat?
I left that hospital appointment dejected and fearful for the future as such high levels indicated that Freddie would be at risk of short and long-term complications if they continued. It was hard to understand why when we had thought we had done everything right. Even the consultant was surprised and insisted on repeating the test. The only possible clue was that Freddie’s levels were slightly higher at nursery.
Despite this we were not judged harshly by the Paediatrician Team who simply decided to review Freddie in two months instead of four and if the results had not improved, we would consider other options including a third insulin injection during the day. Jon and I did not want to subject Freddie to another needle nor ask nursery to administer two injections, when we have been so lucky to find a nursery that will administer injections and do blood tests at all and they have been incredibly supportive and proactive in training three staff members in diabetic care and emergency treatment, without making Freddie or us feel ‘different’.
We resolved to avoid this and began a stricter diet as unpalatable as this may be (pardon the pun). We carb counted more carefully and researched ‘free’ foods that wouldn’t affect blood sugar, such as peppers and tomatoes, which Freddie could eat anytime and passed our knowledge on to nursery. Freddie’s insulin regime was adjusted and we checked in more frequently with the nursing team. In essence, we became more aware and educated about the condition resulting in greater understanding.
We also checked Freddie’s nursery diet sheets with a sharper eye and one day we noticed something unusual– there was one word that wasn’t normally there– milk. It seems that Freddie was having drinks of milk at nursery ad hoc and we realised that this may be a reason why his levels were higher, because milk contains carbohydrates. Milk provides vital nutrients and is an important part of a child’s diet – it’s just that Freddie was having too much throughout the day instead of just at mealtimes to fit in with his carbohydrate allowance and insulin regime and we didn’t realise this effect. This may not have been the cause and there is no blame, it could just be one of those things; but once we discovered this clue, ad hoc drinks of milk were replaced with water. Another lesson learned.
We still monitored his diet closely, not allowing treats because one piece of cake can ‘hurt’ and ensured he had ample exercise and gradually, blood sugar figures tumbled. All seemed well until Freddie became ill during our holiday and refused to eat, but that’s another blog…
Soon another HbA1c blood test beckoned. Had we done enough? Once again the results were as startling as before, but this time for all the right reasons. Freddie’s blood sugar had gone from 86mmol to 68mmol within two months. Isn’t that simply amazing! We were aware that Freddie’s levels were much lower but didn’t expect that level of improvement. It is a measure of the collaboration and care between Paediatrician Team, nursery and us in looking after and monitoring Freddie that has achieved this.
We have become more aware and educated and this has resulted in good control, which is the key to a healthy lifestyle with reduced risk of complications in later life and is a beacon of hope that such control can be achieved, even at such a young age. This is ACE – Awareness, Control, Education of diabetes = a healthy child growing up with a strong basis for good management of the condition and reduced risk of short and long-term complications.
For now we breathe again and celebrate. Two months until the next HbA1c test – let’s see if we can reduce it even more. That would be Ace.