My seven year old son’s A1c was 10.4% when he was diagnosed with type�1 diabetes about three months ago. Since then his A1c was 9.4% and his last was 9.2%. I’m just worried that his last A1c didn’t go much lower. Is that okay?

I would agree that an hemoglobin A1c level at this stage of 9.2% is not satisfactory: You should be aiming at a level that is less than 1% above the upper limit of normal for the laboratory performing the test.

Getting this put right involves first of all doing a lot of blood sugars over a period of a week or so to get an idea as to when blood sugars are high. In some centers, you can then fax the results in to the diabetes care team and thus save an office visit. Almost certainly, this is going to involve an increase in the insulin dose and perhaps in the kinds and timing of the insulins given. This would in fact be a good opportunity to talk to the team about an increasingly used pattern of very short acting (Humalog or Novolog) insulin at mealtimes. (It is in fact often given just after the meal so that the dose can be adjusted for appetite and the pre-meal blood sugar.) In addition, for basal insulin, Lantus (insulin glargine) at bedtime gives very even 24 hour basal coverage with a single injection.

I think it would help too to have a manual which you can consult at home. There are many good ones which are listed at this website.

DOB