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September 1, 2001

Daily Care

Question from Springfield, Illinois, USA:

My five year old daughter has had diabetes for about nine months, and her A1c's for the last six months have been 6.6 and 6.5% with fructosamine levels of 308 and 301. She has had some lows over this time, and her doctor says that she is in good control. Is he correct?

Answer:

Although you don’t give the specific normal reference range for the hemoglobin A1c determinations, in most labs, values of 6.6% and 6.5% are wonderfully excellent! If your has had her diabetes just for nine months, she probably is still in her honeymoon phase, which we want to last a long time, so don’t get fooled by the fact that if she sometimes goes off her meal plan, her glucose values will remain good because during the honeymoon, her own pancreas is getting “a second wind” and producing some insulin (like short-acting Regular or Humalog) on its own.

With A1c values as low as your daughter’s, I would also caution you to be on the lookout and prepared for lows. Be certain that you are familiar with your Glucagon Emergency Kit.

DS