April 9, 2010
A1c (Glycohemoglobin, HgbA1c), Other Illnesses
Question from South Bend, Indiana, USA:
I’m mom to a nine-year-old son, diagnosed with type 1 diabetes on October 13, 2008, and who also has Asperger’s syndrome. The only time we can control his diabetes is when the care is done by myself or his brother. Things got so bad that his autism doctor had us pull him out of school because the care there was so poor. My son’s A1c was much higher at his last visit with the endocrinologist. But, at his visit today, his A1c was 8.7, down from 9.5 six months ago. Other than diet, exercise and strict care by the three of us, how can we work to lower his A1c even more? Because of his autism, my son is on a very strict diet. He is a very active boy.
You should really ask this question to his diabetes team since they know his details. Usually, what you have listed is the correct list: attention to timing and amount of food, frequent blood glucose monitoring and analysis at least weekly are key. Most people doing intensive care either use multiple daily injections or an insulin pump with carbohydrate counting and correction factors. Depending upon the severity of his Asperger’s syndrome, he may or may not be able to participate and if not, then it depends upon his parents/caretakers to assume this responsibility. With such high A1c levels, for whatever reason, long term complications risks are quite high so please consult with your diabetes team about your options.