September 8, 2008
A1c (Glycohemoglobin, HgbA1c), Other
Question from Gateshead, County Durham, England:
I wish to know whether, according to current thinking, anything can be done to reduce the risk of dead in bed syndrome occurring. From what I have read, the following have been suggested by various people in various places.
taking the usual measures to reduce the risk of nighttime hypoglycemia (such as a bedtime snack, occasional nighttime readings, checking the child during the night for signs of hypoglycaemia, ensuring the blood sugar reading is not too low at bed-time);
being particularly observant for any evidence of hypoglycaemic unawareness and trying to reduce this as quickly as possible by aiming for slightly higher readings for a few weeks;
not aiming for too tight control.
Is it worth doing any of these in the hope of reducing the risk of a twelve year old girl dying from this syndrome and, if so, which?
Am I correct in thinking that the A1c reading, even if suggestive of not too tight control, could still allow for many readings below 4 mmol/L [72 mg/dl] if these are offset by a lot of above average readings?
Answer:
All these are quite reasonable approaches. All must be individualized for each person/child/teen. It is best to talk to your care team for more specific advice.
SB
[Editor’s comment:
With respect to your last question, you may wish to read a previous question explaining a bit about A1cs.
BH]
