My 15-year-old son was diagnosed on January 22, 2008. At that time, his blood sugar was 1253 mg/dl [69.6 mmol/L] and his A1c was 9.0. On May 15, his A1c was 8.2. On July 31, his A1c was 8.9. The diabetologist was okay with the last A1c saying he had grown two inches and lost 2.5 pounds in three months. We are not using a correction factor. The doctor wants us to wait until September when we attend “Advanced Diabetes Management Class.” Friends of mine that have children with diabetes say that his A1c is too high, that it should be “in range.” What is your opinion?

This is a hard question to answer because diabetes management is personal. I tell patients that we doctors actually treat people and not paper. I sometimes have had patients say, just let me check my A1c and if it’s okay, I don’t need to see you. That’s paper, not people. I actually look at you, check your blood pressure, make sure your thyroid isn’t enlarged, and look at injection or pump sites. Your A1c may be okay because you are having dangerous lows you aren’t seeing because you don’t graph the glucose data and look at it. Regular visits are essential. I know some complain that they seem rushed; often they seem that way to the doctor, too. Given the number of people with diabetes and the number of doctors who treat type 1, we are just overwhelmed, but we are trying, I promise you that. I expect your doctor has safety concerns and wants you to be educated first.

That all said, and since all I have is the 8.9, I would hope by now it is lower. You do have a plan…attend and learn from the advanced management class. Unfortunately, it isn’t till September, but it is a good plan. Too many don’t have that. Between now and then, try to learn more….there is lots here on our web site as well as other sites.

LD