Perfect Endo Visits

Or last two Endo visits have been perfect in my opinion. Our A1C has remained 6.9 and I’ve become happy with that at this stage in Liam’s life. Staying under 7% and bringing down the severe low percentage is really our only goals.

Or last two visits have gone down like this…

Endo:. You guys are doing everything right. Any concerns or questions you have for me?
Me: No (unless prescription charges or questions).
Endo:. Then we’ll see you in 90 days!

They have learned that we know what we are doing and we can discuss, intelligently, any choice we have made for Liam, and the rationale behind it.

Thanks to FUD for making these visits so easy for us. Our most recent major shifts are becoming full time sugar surfers. This change has helped us avoid strict timing and let’s Liam eat any time he wants.

He is 40 lb and 3 ft 3 in., so falls in the 30th/40th percentile and the Endo team are happy with his growth curve.

Thanks FUD!

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Glad your endo visits are effortless, along with the great control you have over your son’s diabetes. That is fantastic that you are also working to have him not have to stick to a strict schedule. School will impose that on him soon enough.

If you have extra time with your endo (I feel like we paid for the visit we might as well get our moneys worth) one thing you might want to ask your endo about, is what studies they have seen or are on the horizon that might change the care paradigm for your son.

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They have been pushing me to the G6 and Omnipod Dash but I don’t like changing things that are not broken. Especially for technology that has problems or hasn’t been vetted enough for my taste.

Thanks for the recommendation! We have also previously been asked if we wanted to join a test trial but we were just so busy we didn’t follow through with it. We definitely need to be forward thinking/looking so I’ll start doing this in the future… Make them earn their money! Lol

Just got a thought/question. Do you all think the school nurses are going to have issues with sugar surfing? Do they know what it is? Or do you think we are going to have to go to a strict schedule in school?

I think the issue will be that they won’t have time for it. I’m also not sure I would trust them to do it - sugar surfing sorta requires an experienced person to be able to predict where the CGM graph is heading.

Almost definitely not :slightly_smiling_face:

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So, sugar surf at home, but strict schedule at school. Got it. Thanks!

I think it is unlikely that you will find a nurse with the time and knowledge to pull that off. You have a shot at sugar surfing, assuming you have a well trained confident nurse, and you can reduce your rules to an algorithm, but like @glitzabetes I wouldn’t count on it. However, I would think by third grade your son might be capable of doing it on his own.

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I don’t know about the G6, but is seems like there is not much benefit to Dash. They (endos) are probably pushing for it because they believe it gives them better access to his data. I have absolutely no reason to switch to it.

Possibly the one thing it would do for you that might be useful is allow you to set a 0.00 unit segment in your basal program. Not just as a temp basal, but having 0.00 programed.

That could possibly help you, as I believe there were times you had where 0.05 units was too much basal, right?

Other than that, I see no reason to switch.

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Yes, they mentioned “easy data access” with the dash. Yes, we have to suspend basal sometimes all night…but I’m fine just suspending it for x hours as necessary…no need to upgrade for that.

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yep. Pretty sure that you’ll be required to not sugar surf.

When at school. But managing two systems may be a challenge. lol

I think it’ll be fine. WE sugar surf when we want, or closed loop when not. It’s really just about understanding the numbers and you can pretty easily pick back up once he gets home.

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Glad your visits have gone so well!

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Yep, I don’t think it’ll be an issue. I can definitely see how sugar surfing may be too time consuming for school nurses. To successfully surf, you have to understand trends and when to correct so it takes vigilance. Nurses have multiple kids they’re looking after so it would be a lot to put on their shoulders and probably not a reasonable expectation.

It also depends on your district. We had one kiddo in our new to diabetes class whose mother had successfully lobbied for a para to be in the room for their kid, and the para was trained to treat the boys diabetes. I personally wouldn’t have wanted that for my kiddo, but this parent felt it was needed and the school complied.

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I am aiming for this for Samson because the alternative is that the kindergarten teacher needs to learn how to answer his alarms and bolus him. There is no onsite nurse unless there happens to be a kid with very special needs at the school.

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My Endo told me to shoot for 180. He said that would keep my A1C around 7. My problem before I got Dexcom G6 I think the lows were balancing the highs. That is actually not good because I was never staying around 180. Now I can watch on my graph and correct before it spikes or drops!

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My charts say if you average 180 you will get HbA1c of 8 - to get one of 7 you need to average 155.

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“Shoot for 180”, may have meant to stay below 180, not average 180.

I recall in old days on NPH + Reg, to shoot for 200 as highest after meals, and it meant I was doing great.

I am currently aiming for between 72 and 180 with the help of my Libre + MiaoMiao - currently averaging 6.5 and in range about 92% giving me an HbA1c I could only dream of in the days of pee sticks and BM sticks.

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