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Question:

From Connecticut, USA:

My 21 year old son recently had an A1c of 6.9%. His doctor says that's fine, but my son wonders if it could be better. He's switched to a new doctor who might not be as rigorous about control as his past doctors were.

Answer:

It sounds like your son is very engaged in his diabetes care, and that is to be commended. Hemoglobin A1c is just a piece of the complex puzzle of managing diabetes, an important piece, but not the only piece. A result of 6.9% sounds wonderful if the normal range is less than 5.9%. The famous DCCT study on type 1 diabetes showed good long term outcomes with a hemoglobin A1c less than 1% above the top of the normal range. In the DCCT, the normal range was 4-6%, and the results were best when the results was 7% or less. However, the result alone isn't everything.

How is your son doing overall? Does he have many low blood sugars daily, weekly? If he has more than one low blood sugar a week, he may be sacrificing quality of life for a good hemoglobin A1c result. This lab result shows the "average" blood sugar. That could mean a lot of highs and lows which average to a "good" number. This is why the hemoglobin A1c result is a piece of the puzzle. If he finds that he rarely has a low blood sugar, and he is able to enjoy a good quality of life and his hemoglobin A1c is within the target, that is wonderful. If the only thing good is his hemoglobin A1c and he's scrambling to stay above a low blood sugar, this needs further investigation.

KS

DTQ-20000821214345
Original posting 4 Oct 2000
Posted to Tight Control

  
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Last Updated: Tuesday April 06, 2010 15:09:14
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