My niece, who is 15, is coming to spend two weeks with us. Her A1c level is at 10.5 and should be around 7. Her mother does not restrict her eating or require her to exercise. I certainly don’t want anything to happen to her while she is in my care. Both of my parents are diabetic, so I have had some limited experience with the disease. If we limit her carbohydrates to what her doctor recommends, and provide her with alternate, healthy snacks, will the drastic change in diet put her at any risk? Is their imminent danger in her A1c being so high? What do we need to look out for?

Good for you for wanting to provide a safe two weeks for your niece! First, you are correct that an A1c of 10.5% is very high and suggests several weeks of average high blood glucose. There is no immediate danger in a high A1c value. Rather, the risk for diabetes complications is related to long term high blood glucose levels. What you will be doing for the two weeks will have some effect, but will not completely bring her A1c to target.

I would suggest that you follow her prescribed diabetes care plan as closely as possible. Adding exercise (physical activity) and decreasing carbohydrates may put her at risk for hypoglycemia. Become familiar with the usual symptoms and have carbohydrate snacks available during activities. At age 15, your niece will probably know just what to do to identify and treat hypoglycemia.

One more thing, try to avoid becoming the “diabetes police” during your time together. Teenagers enjoy independence and often believe they know what is best for their diabetes care. Your support and role as a coach, while avoiding constant questioning and correcting, will be a tremendous boost for your niece.

BS