I am 16 years old, have had diabetes since my sixth birthday, and, for the past two years, I have kept good control. I test all throughout the day, about twelve times in all. My last three hemoglobin A1c tests were 6.4, 6.1, and 6.7%, but I have been getting higher blood sugars than I would like, which some are in the high 200s mg/dl [11.1 mmol/L] and a few in the low 300s mg/dl [16.7 mmol/L]. I have heard about all the complications with diabetes, and am worried about not living a full life. I eat relatively healthy and exercise everyday. I am 5 feet 7 inches tall and weigh 138 pounds. Can you please tell me if my hemoglobin A1c tests are okay and what I need to do to prevent complications and lead a full and healthy life?

Wow! I am very impressed — not only with your excellent hemoglobin A1c values, but your maturity and insight. Right now, I don’t see any reason for you to be worried about diabetic complications and not continuing to lead a full, active, productive life!! However, if you are seeing some persistent higher readings, or a pattern of the higher readings, (like higher readings at dinnertime rather than at breakfast), then you might need a slight adjustment in your insulin dosages or meal/snack planning or activity.

You don’t indicate what insulin regimen you receive, but many active teens like the flexibility to be on a Multiple Daily Injection (MDI) plan of long-acting Ultralente {or possibly Lantus (insulin glargine)] with short-acting Regular, Humalog or Novolog. If you’re not on one, you might also want to consider an insulin pump. If you are already on these more intensive regimens, then I think a pattern of higher glucose readings should prompt adjustments in the dosing. Keep up the good work!

DS