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December 30, 2002

A1c (Glycohemoglobin, HgbA1c), Blood Tests and Insulin Injections

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Question from upstate New York, USA:

My son has to have blood work every so often, but I can’t remember. what it is they check for and cannot get in touch with the doctor to ask. All I know is his rbcc didn’t come back well indicating that his average levels were too high. I want to look up info on what this means but can’t remember the technical words.

Answer:

From: DTeam Staff

Ain’t no such test as an rrbc. RBC stands for red blood cells. I suspect you are talking about hemoglobin A1c or A1c test. At minimum, he should have an A1c every three months, lipid every year, kidney functions yearly after five years of diabetes or adolescence, thyroid functions and thyroid antibodies. Most people now are adding a test for celiac disease called transglutaminase antibody. Thyroid abnormalities co-exist with type 1 diabetes about 20% up to 40% of the time. Celiac disease about 5-10% of the time. Lipid abnormalities from 20-40% of the time. The discrepancy is related to what cutoff levels are used in different studies.

In the DCCT, we obtained A1c levels monthly so if you are striving for DCCT level control, you may want more feedback. If abnormalities in lipids, thyroids, kidneys etc, then one should test more frequently and monitor more frequently. Same if there are family history factors, already existing blood pressure problems, retinopathy, nephropathy, neuropathy, etc.

You should discus this with your health care team since they probably have a system of what they suggest. You should learn what this is and then adjust it individually for you or your child. The system that we use was published in several journals over the last few years. The American Diabetes Association also has a list of suggestions but the ADA list is a minimum list. ISPAD also has guidelines of what should be tested and how often. All are available at links or via other places on this website,

SB