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February 15, 2016

A1c (Glycohemoglobin, HgbA1c), Meal Planning, Food and Diet

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Question from West Chester, Pennsylvania, USA:

I know my 15-year-old relative with type 1 is cheating by eating candy, lots of it. She thinks that as long as she does the insulin injections, that will keep the A1c results within range. Will eating this candy (ingredients: corn syrup, dextrose, sugar, high fructose corn syrup) show up on her A1c testing even if she is taking insulin to keep her blood sugar in range?

Answer:

From: DTeam Staff

Thank you very much for your question about your teenage relative with type 1 diabetes. There is much misunderstanding and confusion about diabetes care, so it it wonderful that you have asked.

First of all, the absolute best thing a caring relative can do is to see how you can be supportive to your family member, and to understand that no one is perfect. It is very hard for a person with diabetes to feel that everything they do and eat is being watched, so the more you know, the more you can be helpful. Food is one important part of diabetes care, but there is so much more that your teenage relative needs to do to take care of herself. It is exhausting, never lets up, and is too much for most teenagers to do well. I would try not to use negative words such as “cheat” and instead try to find a positive approach to support her. From your summary, it sounds as though your relative sees a diabetes specialist, so he or she would be the best person to assess her care and speak with her.

A teen with diabetes should be encouraged to eat healthy food, as should everyone. Unfortunately, in our society, in general, we don’t eat very well and most of us should make changes in how we eat.

As far as your question about candy, yes, she can eat candy, especially if she times it with exercise (when more carbohydrate may be needed to prevent a low glucose with exercise) or if she matches her insulin to it. However, eating a lot of carbohydrates like candy is not healthy and may make it a bit harder to keep her glucose levels in range. As far as the A1c result, that blood test gives an overall picture of how the glucose has been over the past few months, and candy per se wouldn’t show up on the A1c unless her glucose levels were high as a result.

In summary, I would want to make sure she understands the best way to eat candy with the least detrimental effect on her diabetes self-care, and also to make sure she has the support (emotional as well as diabetes-care support) and encouragement she needs to take the best care of herself that she can through these tough teen years.

LM