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Question:

From Wyoming, USA:

My three year old daughter (diagnosed 5 months ago) just had her first A1c test and it came back 9.7. My husband and I are quite aware that tight control (within the guidelines for children her age 100-200) is the very best thing for her and were quite upset with the result. As a result we have been taking more frequent (up to 8 times per day) readings and have noted highs after every meal and especially after treating lows. Are these highs causing this A1c reading? The numbers at the times we are supposed to take her sugar are within the target range 90% of the time. Is there any reason we should not be taking her blood sugar so often?

Answer:

A number of things to consider here. First of all you are doing far too many tests -- 8 per day is only justifiable if a child is ill and you will quickly give her sore fingers and make her reluctant to play ball.

It's early days yet and you should discuss with your diabetes team what target they have set for her -- HbA1c values vary from lab to lab. Yes, the fluctuations are probably responsible -- swings from low to high and back are sometimes due to too much insulin -- once again discuss. Certainly, don't be tempted to just keep bumping up the insulin if she's having frequent hypos.

Finally, although you are perfectly correct that long term control is very important, your daughter will not come to any harm from a short period of poorer control and she is likely to have several more during her childhood -- it's the long term that counts.

KJR

Original posting 13 Feb 1999
Posted to A1c, Glycohemoglobin, HgbA1c

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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