I found this, because I am confused

I have not posted on here for a while, but Jacoby's (age 5) a1c just came back at 7.9. I was appalled, however his doctor seemed fine. He actually was not too happy when it was 6.9, so I am confused. I will say however that advice I have received from adult diabetics who are healthy and have little to know complications from their diabetes say not to run them to low. That running to low affects intelligence and health. Have an appt the 14th going to follow up more on this.

typo's always happen when I am passionate about something. I really do know how to spell, lol.

I think the physician is just being cautious. Because children can often times be much more insulin sensitive (even without factoring in hormones at some point, which complicates it even more), they often times can go experience hypoglycemia and may not realize it. Additionally, they may not have the forethought or capacity to understand that they just ate some carbs but because they're about to go outside for recess or about to go run around in the yard playing vigorously for an hour, that perhaps they shouldn't bolus their total amount to cover that food. Things like that are a bit more tricky and can usually be more readily comprehended by an someone who is a little older (and a little more experienced with the situation). So trying to have a child take care of these things and walk that fine line at the 5.5-6.5 range is very tricky.

And yes when he gets older, it will be important for him not to have hypos during class or during exams...there have been several studies showing the deleterious effects on overall comprehension and performance.

I'm not saying I would "love the 7.9" either, but I think there's probably a more appropriate middle ground for everyone involved in order to have sufficient control without experiencing too many hypos that adversely affect quality of life. Hopefully you can find this middle ground when you have your follow up appointment next week!

hi obismom, considering the age of the diabetic is very important, I agree with brad's reasoning conversely we know our children and really are their best 'doctors' in finding a middle ground between safety and risking complications. especially for a 5 year old I think 7.9 is reasonable my son is 15 and has run between 7 and 8 his whole diabetic life, 5 years, his recent was his best ever 7.1, I tell him he can wait until he is a grown up to join the 6 club!! keeping in mind at this age he can totally be part of the team and know his own body and self adjust based on what he is doing ect, sometimes due to concern like a sleep over I still recommend he run himself high! that being said if at 6.9 your son wasn't having many lows and things were going pretty good all the power to both of you! I sometimes think we fall to much into the number game good/ bad, doctors visit equals report card day ect. know wonder why adults can get burnt out! it is important for us to teach our kids to use the numbers as guides not as good bad anything. also to expect a child to have an A1c close to normal or even a grown up is in most cases a very unrealistic and unsafe goal. when things are going poorly for us or if that A1c creeps up or slightly over 8 I am still grateful we have better insulin and knowledge than there was even 30 years ago when most kids probably sat in the 10-15 A1c range hence leading to complications. staying close to 8 for a growing child I think is fine. this is the long haul and as your little guys has growth spurts or becomes ? less than perfectly compliant due to burn out or apathy as a teen that number could go a lot higher. setting him up now with reasonable expectations and lots of praise will set the stage hopefully for stability in the supposed rocky teen years which we haven't hit due to our knowledge and support and a boy with a 'diabetic' personality rule following, compliant take it as it comes attitude, best wishes, amy

Hi. Thanks for this post. We are 1 year in after our daughter's diagnosis. She is 2 years old and look like a normal healthy baby to us! We just received her test results and they are a 9. When the doctor phoned he left a message saying 'normal'. Then I received the results and was stunned. Her first a1c test after diagnosis was 14 - said he wasn't concerned because of her age.

We keep her average blood sugar level at 8 mmol. She's very active as are most children so when it goes much lower we start to dip into hypos and notice it plays with her mood. Not letting them run to low was exactly the advise we were given.

I think with little ones you have to be even more cautious, once she can start to communicate more about how she feeling I am sure you can be a tad bit more aggressive. best of luck, amy

Thanks so much for the input. I like these forums where we can all "compare notes".

Hi, it might also help to know that with kids in this age range (my son is 6), there is an expectation of a1c's in the 7 to 8 range because of the effects of growth hormone. Growth hormones increases the body's resistance to insulin, probably as a mechanism for making sure that there's adequate fuel around to provide for the extra metabolic strain (same reason why kids sleep more when going through a growth spurt). If your son was at 6.9%, it suggests that he's having a great many more lows than is desirable, which is not good for either his growth or his brain development. And in particular, if the numbers coming off his meter don't reflect a great many lows, it could mean the lows are happening overnight, which is when you WANT the numbers higher.

My son's endo encourages me to keep him between 7 and 7.5 if I can, but I know he doesn't want him any lower than 7 and he gets antsy if we get numbers higher than 7.8. My understanding is that it's not until his brain and body have reached full adult development that we're supposed to shoot for numbers in the mid sixes.