April 12, 2005
A1c (Glycohemoglobin, HgbA1c), Pills for Diabetes
Question from Raleigh, North Carolina, USA:
Our daughter is 10 and was diagnosed with type 1 when she was 2. She is currently on an insulin pump. She has always been hard to get into good control. Her A1cs stay in the 9s and occasionally the 8s but never any lower. Her endocrinologist is talking about putting her on Glucophage along with her insulin. Is that a common practice?
Answer:
Glucophage (metformin) is sometimes used as an adjunct in obese children with type 1 diabetes to increase insulin sensitivity, especially in an obese adolescent. The A1c levels that you describe are very high risk and usually seen with infrequent blood glucose monitoring, omitted insulin, major food indiscretions or severe individual and/or family distress. If you and your diabetologist/diabetes team do not have a good explanation for the high A1c levels, you may want to consider a special trial with the MiniMed glucose sensor to see if this answers some questions.
SB
