August 28, 1999
A1c (Glycohemoglobin, HgbA1c)
Question from Yahoo:
My son has had diabetes since he was one year old; he is now 4. He has been in great control. His last A1c was 6.9. We are concerned however because we feel this excellent A1c is not a result of consistently being within his target range of 100-200, but rather from averaging his highs and lows. We have been told keeping a child of his age within target ranges is not an easy task. The A1c is supposed to be an indication of your chances of developing complications later in life.
If your A1c is a result of averages from both high and low blood sugars, and not necessarily from “hitting” your target blood numbers, is that great A1c a valid indication that complications can be delayed or avoided? My husband and I feel that there has to be some adverse effect to the huge “swings” in blood sugars.
Answer:
Controlling blood glucose in any child under 5 is extremely difficult, and to have an HbA1c below 7% is fantastic. Well done!
The HbA1c is an indication of what the blood glucose is doing for most of the time. Having even extremely high blood glucose readings for short periods in general will have little influence on the HbA1c. If your child has been having high readings, then presumably these have not been consistently high and so have not had a great impact on the HbA1c.
The HbA1c is so far the best predictor of outcomes we have. Inevitably there are going to be high readings, just as there will be low readings. Very low readings are just as important to try and avoid. Keep up the good work.
JS
