Every meal you try your best. Every night and every day, you always try your best. You always try to have the best BG. And as the A1C gets lower, you see the results of your effort. You know you are on the right track.
So this is how we try to do things and very much how I think of things on a good day. But the reality is that Samson has two caregivers at home and four to six caregivers at school, Not all of them are always trying their best, and diplomatically speaking, some of those peoples’ best is still quite lacking. Not to mention that we’ve had so.many.problems with the G6 that leads to data drop-outs for a few hours almost every night – and of course it’s always when it counts. So right now, we as parents are not pushing ever harder to lower his average BG, keep him steadier, etc… so much as we are trying to put out fires at school for instance, dealing with poor and delayed communication with an ever-changing tableau of teachers, reinventing the wheel as we continually tweak the care protocols to make things easier for him, figuring out how to navigate around unreliable sensors, and struggling with crummy WiFi problems that knock openAPS out randomly.
We’re in a state of stagnation right now; that’s not great but what I’m saying is that at this point, we’re sort of okay with treading water because I see his A1C is okay, and I tell myself “this number is telling me we are doing an adequate job for now – when things settle down or he gets older or circumstances change for the better, we will start pushing for that continual improvement again.” If there was stronger evidence that a super low A1C could erase all his risk of complications though, I probably would start thinking really outside the box and not be okay with this treading water right now, even for another 9 months. (Maybe I’d take him out of school or attach two different types of sensors to him, change his diet, etc. etc…) Given all these external sources of variability, we aren’t keeping super tight tabs at every meal, documenting every bolus for inspection, making absolutely sure he carries his phone with him at all time, or even going over Samson’s numbers and settings every week like we used to.
That’s not ideal of course, but the fact is that A1C is the only measurement that’s been well established to be correlated with complication risk, so it’s a reassuring number that tells us we’re doing okay for the time being – that it’s okay to mentally take a breather on that “better and better and better” attitude for a second while we catch our breath.