My daughter recently had an A1c level of 7.0. At diagnosis, a year ago, her A1c was 7.0, then it was 7.3, then down to 7.0. I have read it should be 6.5. The doctor said she is doing well and would not change anything. Shouldn’t it be more towards 6.0?

Good question. There is debate in children and even adults about A1c.

First of all, 7.0 is good.

Now, what is the A1c? Essentially, it is the average glucose. So, if the average is 150 mg/dl [8.3 mmol/L], it can come from 50s mg/dl [2.8 to 3.2 mmol/L] and 250s mg/dl [13.9 to 14.4 mmol/L] or 125 and 175 mg/dl [7.0 and 9.8 mmol/L]. We want to avoid the lows and the very highs. The scientific term is average and standard deviation. That is the more important question…best A1c for the fewest lows. Younger children may not have the skills to recognize the lows and then be able to take care of them all by themselves. School and help there is also important.

I personally download all meters and actually look at the glucoses and the patterns so I can understand highs and lows, not just the average.

So, the famous “Strive for 6.5” is a good motto, but needs to be carried out with careful management and very individual attention.

LD