I received Austin's latest A1C test results this week and I was so happy I could have cried. His average blood glucose control for the last three months was 7.1 (which converts to 157 mg/dL). It's the lowest it has been since before his T1 diagnosis. While it's still not as low as I'd like, it's below the American Diabetes Association's A1C target of 7.5 for children with Type 1 -- for that I'm very happy.
I credit his 7.1 A1C to Bo's alerts and the fact he and Austin spent most of the summer together 24/7. Their 'togetherness' provided the opportunity for Bo to catch more reward range blood sugars than during the school year when they are apart from 8 am to 3:30 pm.
What I consider most remarkable about Austin's 7.1% A1C is not the fact that it was achieved with the help of Bo's nose but rather it was achieved without a continuous glucose monitor (CGM), without a disproportionate number of hypoglycemic events, and with the presence of growth and puberty hormones.
If Austin had a continuous glucose monitor it would provide valuable blood glucose trend data that would help us fine tune his basal rates more precisely. We have talked about getting him a CGM but he is vehemently opposed to having another site on his body. (He has an insulin pump site already.)
When it comes to A1C numbers, Austin's endocrinologist wants to see a low result but does not want that result to be the effect of a large number of low blood glucose events. Thankfully, Austin's 7.1 A1C was a result of staying mostly between 90 -200. Bo is trained to alert on highs starting at 170 and when he is with Austin he is typically alerting right between 170-185.
At 13, Austin is in the throngs of hormonal changes that are known to make diabetes management even more challenging. As we adjust Austin's insulin therapy during this period of rapid growth, it's helpful to have Bo alerting on high and low blood sugars before they pass from 'not ideal' to dangerous.
The next milestone on our journey is registering and licensing Bo with the NH Governor's Commission on Disabilities as a trained service dog. Once that happens, my plan is to begin talking with Austin's school about scheduling short visits to trial boy and pup working together while class is in session. There is no guarantee that Bo will alert to Austin in school but I'm hopeful. If boy and pup are able to successfully work together under the distractions of a busy junior high, I'm confident Bo's nose will help us maintain or even reduce Austin's A1C through the school year.