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racinghoss

What do your Dr's tell you? A1c goal? BGL goals?

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racinghoss

My daughter seldom visits the same Dr. We are a military family, and use military medical facilities at Walter Reed Army Hospital and Bethesda Naval Medical Center. Because the Dr's are also military, they transfer in and out or deploy on a regular basis. We have seen different Dr's for our last several visits. Although they all work on the same team (pediatric endo), they dont all have exactly the same advice. Sometimes there are slight variations.

 

My daughter is 10 years old. Dx'd at 6 years old.

 

They want her A1c slightly above 7.

 

We were 7.1 last visit and they were happy. They explained that the higher A1c for childen was to prevent possible deficiencies in brain development (dont want to starve the brain).

 

They gave a BGL range of 80-180, with a goal of 150. Hypo starts at 70, Hyper starts at 200.

 

Can anyone with T1 kids please add what their Dr recommends, for comparison?

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k_dub

Hi racinghoss,

 

I was diagnosed with Type 1 as an adult, so I cannot speak to you about differences between recommendations between adults and children. But as far as I read, the recommendations are the same.

 

I, personally, would not be happy about the BG targets that they set.

It is possible, even for Type 1s, to have pretty normal blood sugars most of the time (80-100).

I try to stay in that range as much as possible and I don't like it when my BGs rise above 140 after meals. (Not that it doesn't happen).

I think an A1C above 7 is dangerous. ADA recommends it to be under 7.0 and most of us on the forum believe it should be lower.

 

Does she have hypos frequently? Did they recently change her insulin regime? I can see them giving you guys some time to adjust to a new regimen, etc - especially if she has frequent lows, but those numbers seem high to me over the long term.

 

Did the doc explain to you why they wanted her to shoot for 150mg/dl?

 

Of the two endos I've had, they wanted me A1C under 7.0. My fantastic GP/FNP wants it lower than 6.5 and as close to normal as possible without serious hypos. I usually have an A1C around 6.1. But I over indulged over the holidays and am up a little.

 

If you check out some of the threads on the Type1 boards, there are many people who have A1Cs in the 5.5-6.0 range without having serious lows.

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foxl

Everything I have read about kids is that yes, they should run higher. They are more active, for one thing, so they would be more apt to run the risk of a hypo. Not sure what pediatric guidelines are, you might check the American Association of Clinical Endocrinologists' website.

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racinghoss
Hi racinghoss,

Did the doc explain to you why they wanted her to shoot for 150mg/dl?

 

I am assuming that the goal of 150 coincides with the highter A1c goal. I doubt she would have an A1c at 7 if her BGL goal was 100.

 

She does not have many hypo's or hyper's; and very few that cannot be explained.

 

Her regime has not been changed recently. She has been on the same program since school started in August with good results.

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