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December 4, 2005

A1c (Glycohemoglobin, HgbA1c), Insulin Analogs

Question from Everett, Washington, USA:

My seven year old daughter has had type 1 diabetes for a little over two years now. She is on NovoLog and Lantus. We are very careful about the right dosing when she eats, but her A1c just keeps going up. I don't feel the NovoLog is always fast acting in her and, lately, I feel that if we don't have her blood sugar at 250 to 300 mg/dl [13.9 to 16.7 mmol/L] at bedtime, then she goes low during the night. Is the high bedtime blood sugar causing the high A1cs? Should we consider giving her the Lantus at another time of day? Right now, she gets it at 8 p.m.

Answer:

I certainly would try Lantus in the morning. It does have a “little” peak. You don’t want a blood sugar of 300 mg/dl [16.7 mmol/L] at bedtime. It will contribute to a higher A1c.

LD