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June 16, 1999

A1c (Glycohemoglobin, HgbA1c)

Question from West Virginia, USA:

My son who is 6 1/2 has been had Type 1 diabetes since he was 3. We just had results back saying that his HA1c is 8. They say this is high. When they change his insulin to more units daily, his blood sugar drops too low. Usually his blood sugar see-saws even thought we feed him good. Any suggestions?

Answer:

It is hard to comment over the Internet, but I would say that a hemoglobin A1c of 8% in a 6 year old is respectable. We would love to see the hemoglobin A1c lower than 8%, but not if it means too many low blood sugars. Given the current tools we have and the level of difficulty, I would usually give a goal to my patients in this age range of 7.5-8.5%, but it depends on the individual situation.

Have you been working with a diabetes care provider that is experienced in the care of kids with diabetes? Do you have the advantage of a team that would also include at least a pediatric dietitian and nurse educator?

LM