February 23, 2002
Daily Care
Question from New Delhi, India:
My 15 year old son, diagnosed with type�1 diabetes a little over two years ago, is taking Mixtard twice daily and his A1c is varying (8.3 to 11.6%). His fasting sugar is generally less than 100 mg/dl [mmol/L], but his evening level is generally high ( about 300 mg/dl [16.7 mmol/L]). Do you recommend a change of insulin?
Answer:
Your son’s high hemoglobin A1c is not acceptable nowadays and should be decreased in order to assure him normal pubertal development and a normal life without chronic complications. I think he needs a prompt change to a basal/bolus insulin regimen or an insulin pump accompanied by diabetes self-management education with a proper pediatric diabetes team. It might not be easy to access in your country, but I am aware of good diabetes teams operating in New Delhi.
MS
