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July 3, 2000

Blood Tests and Insulin Injections

Question from Tracy, Minnesota, USA:

My 4 year 9 month old son has had Type 1 diabetes since he was 15 months old. His doctor has never suggested checking his cholesterol or any other blood test other than A1c. Would this be beneficial at his age? Also we do not check post-meal blood sugars. I am concerned that he spikes after meals. His A1c has been around 8.1 to 8.7 range since his diagnosis. We check him 4-5 times a day now.

Answer:

I’ll answer yes indeed to the first question, if there is a family history for lipid disorders, high blood pressure or heart disease. This would help to track his cholesterol level during childhood and eventually intervene with dietary modifications around school age and lowering agents later on.

I think he needs no other test beside HbA1c and routine tests to monitor diabetes. Post-meal spikes of blood sugar levels are important for older people (post-pubertal ages) and I’d concentrate on how to decrease his HbA1c levels towards a value closer to 7% through a intensive treatment based on multiple doses of Humalog which should better control post-meal spikes.

MS