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March 6, 2001

Daily Care

Question from North Carolina, USA:

My 10 year old son has been on insulin since the age of two. His hemoglobin A1c is now up to 8.3% and I've been told it needs to be 7.5%. We are now carb counting to try to lower it, but his blood sugars are still erratic and hard to control. I worry about his long term health, should I? Any ideas that would help us manage him better?

Answer:

The best way I’ve found to really tighten up control of blood sugars is to make frequent adjustments to insulin dosing. Carbohydrate counting will likely give you the best results. I would suggest keeping good records and reviewing them with a knowledgeable person on your son'[s diabetes team each week until you are seeing the results you like. You and your son might also consider an insulin pump. This is more work, but offers a better chance to micromanage diabetes and lower your son’s hemoglobin A1c.

Also, have realistic expectations. You will never be able to eliminate the erratic days completely. A good goal is to work hard to minimize the number of highs, lows and erratic days.

MSB