My 10-year-old son, diagnosed with type 1 at the age of two, pumping since the age of four, has high cholesterol (189, normal range 125 to 170) and high creatinine (199, normal range 85 to 125). He is in the 50th percentile for both height and weight. His most recent A1c was 7.5, up from 7.3 five months ago. I was told that these abnormal findings (cholesterol and creatinine) are indicative of poor blood sugar control. This is the first time these are abnormal. How are these findings indicative of poor blood sugar control?

I would disagree. The A1c of 7.5 certainly isn’t poor diabetes control in a 10 year old. It is likely the elevated cholesterol is familial. What is the family history and do you know parental lipids? It may mean treatment down the line. Some argue that all with diabetes need lipid drugs, the question is when. We won’t solve that question now. I certainly wouldn’t treat now. Learning to eat heart healthy is good for all Americans, diabetes or not. Also, cholesterol is made up of two parts; what are the HDL and LDL?

The creatinine is likely a reading of glomerular filtration; this is hard to do on kids. A better measurement is the microalbumin/creatinine ratio. It is done on a sample of urine.

LD