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July 6, 2000

A1c (Glycohemoglobin, HgbA1c)

Question from Ohio, USA:

Is there a study or information available that indicates how long blood sugars are in higher range per day that adversely effects Hemoglobin A1c? Our daughter is 3 years old and diagnosed several months ago. We frequently monitor her blood sugar and notice that, as with other family members who do not have diabetes, after she eats, her blood sugar understandably is high (i.e., 260-350). Then, within 2 hours, it will be within a normal range (80-130). However, there are times when her blood sugar stays up for 3 to 4 hours; especially if she naps. We checked other family members who do not have diabetes to see how quickly they return to a normal range and it appears to be with in an hour more or less. We are wondering if we should pay attention to how long her blood sugar remains in the high range per day or number of hours per day.

Answer:

You ask an interesting question. If you eat 50% of your total daily calories in the morning, it takes about 2 hours to return to baseline, but in the evening, up to 5 hours. Time of day is important.

Your main question though is likely too sophisticated for a 3 year old. You can’t control food and timing well enough to really get excited about return to baseline. I would worry you will then see lots of hypos. When she is older, you might work on this aspect of care.

LD