KD had her 3 month check up yesterday with the endocrinologist, or her diabetes doctor as I call her. Her A1C is at 8.4 our goal is 8. In Our Diabetes story I mentioned that the A1C is a test that measures a person’s average blood glucose level over the past 2 to 3 months. It was at 8.6, so I guess we are doing better! When she is an adult and better able to control her diabetes, her A1C goal will be around 6, so that gives you an idea of what we are shooting for.
During the visit, the doctor made an observation about her blood glucose numbers from the last three days. She said they had been in perfect range, very rare for KD. She asked if we had done anything different. I couldn’t think of one thing. The diabetes instructor, not a doctor but a very knowledgeable nurse practitioner that helps diabetes families, asked about her site. That triggered a thought. The last infusion set I had put in I put a bit too much on the side. In fact, I had been worried that it was too far over. KD will only wear the infusion sets on the backs of her arms and it usually goes right on the “fatty” part of her arm. Well, as it turns out, putting it over to the side had given her a fresh new area and the insulin probably flowed much easier on this new fresh site.
Like I said in my post about Kd’s story, I am learning something all the time about diabetes. Today I learned that over time her arms have become “calloused” in a way. Injecting (or in our case putting an infusion set) in the same place much of the time can cause hard lumps or extra fat deposits to develop. These lumps can change the way insulin is absorbed, making it more difficult to keep your blood glucose on target. So even though we rotate from arm to arm, we need to find other places to put her infusion set.
As a pump user, KD changes her site every 3 days. So her arms only have 3 days to rest in between site changes. Now, by using another spot, we are trying her tummy, she will give her arms 9 days to rest.
There are other spots to try including the love handle, buttocks, and thighs. The only problem is the person has to have a nice fatty spot to insert the infusion set. KD is far from fat, so we have very limited places where the set can go.
