Concerns about uncontrolled Blood Sugar

[ConcernedParent]

I am concerned about my 11 year old step daughter's blood sugar. She lives with her mom and my husband and I are fighting for custody because we are concerned that her sugar levels are not controlled and she is going to have problems later on in life. At the mediation for custody her mother boasted about how well she is doing. She went yesterday to the doctor and her AC1 test was a 7.9.

Here is a list of her recent blood sugars when she was dropped off:

328
250
119
126
339
238
226
50
230
48
375
199
416
141
153
319
71

Is this controlled/normal for a child?

[Subby]

I don't know what is normal for a child, if there is such a thing. A couple of observations though.

First, those numbers don't represent an A1c of 7.9 in my experience, they suggest this testing period was more problematic than the last three months generally have been.

7.9 isn't great, you'd want improvement for sure, but in the scheme of things isn't terrible at all. For a child who is motivated and healthy I assume you could aim for mid 6s as a reasonable goal.

The BG readouts can't be "read", control can't be judged by a bunch of numbers. They do suggest it's been a particularly bad period. Is she ill or under stress?

Stress in an enormous impact on both blood sugar and on motivation. I have no idea whether you are right in pursuing this course but what comes to my mind is this: be sure this custody battle is not doing the girl more harm than good. In the end her being happy and well adjusted is going to be the best thing for her sugars. And *potentially* big life changing events being made over the issue of her BG control *could* be the worst thing possible.

[RobiJo]

The bgs are a bit all over the place, I'm curious about those 300's and 400 numbers though. How many times a day is she testing? What are her insulin habits? There is a LOT to deal with. Were they after eating? Her a1c is not terrible. Under 7 would be ideal though. Lots of kids and teens run much higher despite heavy parental involvement.

Not sure what the other issues are there for you to fight for custody. Controlling a child's bg's and diabetes is no walk in the park for any parent, and I hope that her a1c is not your only leverage for gaining custody.

As your overall goals you will want to know how to manage the diabetes with your step-daughter AND her mother. It takes a team effort. Like Subby said, stress and other factors also play a huge role in those bg numbers.

[shiftzor]

Well it’s difficult to see a pattern in those bgs other than they are high, I can only give my opinion based on speculation. She is obviously having yoyo effects, for example after both counts of low she has overcorrected, low could be cause by too much insulin/exercise/stress/position of the moon. In that list the average bg is 213 mg/dl which is an A1c of 8.2 and the Standard Deviation (http://www.diabetesmonitor.com/m57.htm) is 114 mg/dl. I would say those aren’t far from her real A1c.

How often does she test a day? I can't imagine how hard it must be for a kid and I really wish I could help you. Normal ranges are between 90 mg/dl and 126mg/dl, however in this case most would suggest that she should be running higher for her own safety. Those bgs are not awful, for example I had an A1c of 14.8 at diagnosis which is 450 mg/dl and that really was awful. There are many things she could do to try to improve her A1c but I understand that’s not what is being asked here. On summary her control seemingly is not really good but it’s definitely not the worst on this forum and further afield.

[ConcernedParent]

Her blood sugar is only one of many many issues for the custody change. I would rather not go into those personal reasons. Our daughter wants to live with us and begs her mom to let her stay longer.

As for her numbers. No this is an all the time thing. She gets HI displays on her meter and LO displays also. I am able to keep her sugars in the target range when she is here with us. Her target is 80-180. Her sugar is extremely all over the place. It is in range only a fraction of the time when she is at her moms. There is no diet or exercise programs that she is involved in.

Also her emergency glucose shot is extremly out of date. There is nothing I can do about that myself. I have informed her about it. I worry if one day she might need it.

[RobiJo]

Her blood sugar is only one of many many issues for the custody change. I would rather not go into those personal reasons. Our daughter wants to live with us and begs her mom to let her stay longer.


Ah no worries .

[ConcernedParent]

I forgot to mention this in my previous post...she checks her sugar before breakfast,lunch, dinner, and before bed. She doesn't check her sugar like she is supposed to at home but when she is with us I make sure that she does since I worry a lot about low blood sugar during the night. She gets insulin 2 times a day breakfast and dinner. If she is going to a b-day party or the likes I give her an extra shot to control the cake and ice cream that she will be having.

I want to thank everyone for giving there opinion about the levels of her sugar. I wasn't sure how bad it was. I always thought that her sugar should hardly ever go over the 180 mark. I feel relieved that although her numbers aren't perfect her health isn't in danger. I see things on tv all the time about many things that can happen to your body if it is not kept under control.

Thanks again everyone!

[KCP]

Just to let you know I had numbers far worse then the ones listed there and I have grown up to be healthy with well managed diabetes..
Dont berlieve everything you see o Tv ;)

[notme]

Eleven years old is a tough age for a child with diabetes. Her numbers are a bit all over, but what you have posted really can't be evaluated as you have not given times that she was tested and meal times. If she was tested thirty minutes after a meal, her numbers will be far more elevated than they would be two to three hours after a meal.

At eleven, your step daughter is on the verge of a huge hormonal upheaval in her life. Numbers are going to be erratic and hard to control. She is also in charge of her meals, for the most part, and when a parent is not around to advise her on what she should be eating and what she should be avoiding. This is a tough time on a kid with diabetes.

An A1c is probably the most effective way of knowing what her blood sugar is doing with the information given. 7.9 is not great, but not uncommon for a kid her age. There is definitely room for improvement, but not the worst I have heard at this very awkward age.

[ConcernedParent]

I agree you shouldn't rely on the tv to give you medical advice. It still scares me though.

I don't understand why when she is here with me her numbers are great.

I just want her to grow up with the proper understanding of taking care of her sugars. I manage her eating and we get plenty of exercise. Just today we went to go play tennis.

As I said before I wasn't sure how bad her AC1 test results were and the flucuating of really high ratings on her moniter. Everyone has made me feel less worried since its not as bad as I thought it was.

Once again thank you!

[LancetChick]

The ADA Parents' message board (http://community.diabetes.org/n/pfx/forum.aspx?webtag=adaparents) is chock full of parents who aren't stingy at all with their opinions and information. I'm not a parent, but I go there sometimes and have learned lots about the difference between diabetic kids and adults, and believe me, there are differences.