My 19-year-old son was diagnosed with type 1 about two years ago. His A1c at diagnosis was 9.8. It is now 7.2. He is on Lantus, 34 units every evening, and NovoLog, 1:12 ratio, with every meal. Our endocrinologist, an adult endocrinologist, did not adjust his Lantus or NovoLog dose at our appointment this week. My son is away at college and our endocrinologist said he was happy with his A1c. I think his doses need to be adjusted. Do we need another endocrinologist?

I work in a young adult diabetes clinic. As a group, this one is more difficult to treat than others. In my opinion, 7.2% is not bad. You have to understand that it is not all about the A1c. The decision to increase insulin doses has a lot to do with activity and whether it will change or not, intercurrent hypoglycemia, ability to incorporate consistently good lifestyle choices into his day, and more. Therefore, this is not an easy yes or no answer. Your happiness with your endocrinologist is personal, but whether this was the best decision for your son is dependant upon more information than you have provided. You might want to talk to your son about the additional issues. This is a time in his life where he needs to be taking charge of the management of this chronic problem.

JTL