My son has had an A1c of 11.5 for a year and I cannot convince him to take his diabetes more seriously. He injects four or five times daily, but sometimes waits an hour after eating to inject. He hasn’t checked his blood sugar levels in six months! He eats and drinks anything a normal person would and, thankfully, is very energetic, and always upbeat about life in general. Now that I am not that involved with his diet and injections he has become totally irresponsible about his diabetes. Are there any statistics of A1c levels this high causing problems over a period of time? How can I convince him to tighten up?

I am afraid that the evidence is overwhelming that having an A1c of 11.5% is extremely detrimental. In the short term, weeks and months, because this is, of course, an indication of very high blood glucose values (insulin lack), there is a considerable risk of deterioration towards ketoacidosis if your son is not careful to monitor his blood and urine if he gets the ‘flu’ or a throat infection. Over the longer term, several years, he is storing up trouble because many of the complications of diabetes are directly and proportionally linked to blood glucose control. The only good news I have is that your son is behaving like many adolescents with diabetes and most likely will settle down. All you can do is to keep gently reminding him of the importance of taking his insulin regularly, checking blood and urine if he feels unwell and attending clinic regularly where they can do more of the same and also monitor for early signs of problems.

KJR

[Editor’s comment: For more information, see the following previous questions on the same topic from

October 2004
September 2004
April 2004

Furthermore, please see The DCCT.

BH]