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July 14, 2006

A1c (Glycohemoglobin, HgbA1c), Daily Care

Question from Union City, Pennsylvania, USA:

My 10 year old son was diagnosed with type 1 when he was six. Over the past year, his A1c has steadily increased from 6.7 to 8.5. We count carbohydrates carefully and his four daily tests are usually within the target range. His dietician recently increased his meals from 60 grams to 75 grams of carbohydrates each in addition to three daily snacks. He is active. The nurse assured me that 8.5 was acceptable for his age due to hormonal changes and growth. He grew an inch in the past three months and weighs about 80 pounds. Is there something else I should be doing?

Answer:

There are 24 hrs in a day and the A1c reflects all 24 hours, not just those four tests that you do. His glucose is going up sometimes, maybe in the night. Ask your diabetes team about the basal insulin coverage and do some nighttime blood sugar checks.

LD