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Young children's A1c range

Discussion in 'Parents of Children with Type 1' started by missmakaliasmomma, Sep 22, 2013.

  1. missmakaliasmomma

    missmakaliasmomma Approved members

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    My daughter's endo says she likes kids her age (5 next month) to have an a1c of about 8. My daughter's is always lower than that (6.6 at her last appt) because I think 8 is too high and I wouldn't feel comfortable seeing the numbers that correlate with an a1c of 8 all the time.

    What is your goal for your child around that age? And what are their actual a1cs like (out of honeymoon)? I would like my daughter to get to 6. I don't know if it's all that possible at her age without being under target too much.
     
  2. MomofSweetOne

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    My daughter wants a 6 because her friend got one:D, but we haven't been able to achieve it yet.

    My daughter didn't have diabetes at that age, but we were lectured by one of the CDEs that an 8 is good, even for an adult. She lost much credibility with me for that comment because I knew several adult T1s whose endos want a 7 at max. I think their concern is too many lows, but with CGM, it's so much easier and safer to avoid lows if the low alart is set at 80 or above. Our endo was surprised at how few lows my daughter had despite an A1C in the 6s when we began CGMing full-time.

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    Last edited: Sep 22, 2013
  3. Sarah Maddie's Mom

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    You say that you want your daughter,"to get to 6" for her A1c. That would be an average blood glucose of 126. And you want this particular number because?
     
  4. Beach bum

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    We go to Joslin and they like kids under age 12 to be between 7-8. Now that my daughter is older, they are happy with her being between 6.5-7.5. We usually hover around 7-7.3. Not bad considering she is 12, growing and coming in to puberty.

    We did have a 6.3 a while back and because we had the CGM and it showed we had few lows, they were incredibly pleased with this. Their main concern is undetected lows.
     
  5. MomofSweetOne

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    We were told without the CGM, they don't like A1Cs under 7 because of the increased risk of lows.
     
  6. Beach bum

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    Yes, I have a friend who's child does not have a CGM and her A1c was 6.2. The team was concerned that there were lows she just wasn't catching. But, my friend doesn't want to trial a CGM to see if that's a problem, nor does she want to do basal testing, so that's that.
     
  7. Traci

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    At that age, our endo wanted our son between 7 and 8.
     
  8. cdninct

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    Our clinic wants all kids below 7.5, regardless of age (DS was 2.5 at dx, and they were aiming below 7.5 even then). They seem to be much more aggressive than most places, though. From ages 4-5, DS has been in the 6s with unpredictable 60s several times a week and at least one lower low a week, and none of the two endos and one APRN we have seen in that time has been concerned. He does wear a CGM, though, so that definitely provides us, and the clinic, with peace of mind about whether we are missing lows.
     
  9. missmakaliasmomma

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    What do you mean why do I want that number? That number to me is an awesome a1c for a diabetic.
     
  10. missmakaliasmomma

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    Her a1c is normally 7.1 for like the past year. It went down at the last appt because on the pump, she had a lot of lows, regardless of what I did. The dr was happy that her a1c went down and I asked her if she saw all the lows when she downloaded the pump.. and I'm SURE that had a lot to do with her a1c being lower. I did tell her that her a1c being 6.6 with a lot of lows wasn't ok with me though. It amazes me that some endos are ok with the amount of lows some kids have..For us, it's been hard to avoid the lows a lot because it seems like some days she doesn't even need insulin.. It's weird
     
  11. Nancy in VA

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    Our target is around 7, but its really more about the amount of lows and highs than the specific A1C. We had a 6.8 but that was with a lot of lows, and two seizures during that time period, so we weren't happy with it. Even with the CGMS, our A1C typically stays between 6.9 and 7.2. When Emma was younger, upper 7s was more the target. If your child is not hypo aware, I think shooting for a lower A1C without a CGMS is risky because the only way to achieve that is uncaught lows.
     
  12. hawkeyegirl

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    I agree with Nancy that if we did not have a CGM, I would not be comfortable with an A1C below 7.

    If you really want an A1C in the low 6s, get a CGM and prepare to sacrifice a lot of sleep. And even then, an A1C in the low 6s is not a realistic goal for most kids.
     
  13. missmakaliasmomma

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    Believe me, I already don't sleep, even pre newborn lol. I test her about 5 times a night. She dips low in the early hours of the morning so I always have to cover that. I actually always thought it was lantus peaking when she was on mdi before, but after changing the lantus dose to the morning this time around on mdi, I realize that her insulin needs lower at that time instead. Also lately, she's been needing less insulin, so I'm testing more frequent because of that as well.

    Don't get me wrong, her normal 7.1 a1c is good for her age, I know that. I just eventually want her to stay in the 6's. I just wouldn't feel comfortable with the "8" that the dr says is good for her age. I'm wondering how realistic it is though for her to be in the 6s when she gets older anyway. I don't want to set myself up for disappointment either if I'm aiming at a goal too high.
     
  14. missmakaliasmomma

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    Right, with her 6.6 she had a lot of lows balanced out with highs but that's one of the reasons we stopped pumping. There was kind of no middle ground with it. She was basically either high or low. Very frustrating. So in that case, I wasn't happy with that number because I knew that it was that low because it balanced out with the highs and lows and thats not good...

    She is very hypo unaware, so you guys have shed light into the fact that her a1c is pretty good for her age and I don't have to worry about getting it lower just yet...
     
  15. hawkeyegirl

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    Have you considered a CGM? I can't imagine living without it.
     
  16. Jakethesnakesmom

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    Our endo has always told me anything under an 8 is the target for kids. Jacob, who's 11 has always been around 7.3 on average (I think right after diagnosis at age 3 he was 7.8 and the lowest I've seen is 7.1) It doesn't seem to matter if we're pumping or MDI, his A1C's seem to hover around the same #. I'd love to see something in the high 6 range, but I'm pretty happy he's consistently in the low 7's.

    Stephanie, Mom to Jacob, age 11
    Dx in 2005
    Currently on MDI (Lantus/Humalog), on pump break from MM
     
  17. Mish

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    oy. Without a CGM I'd be also worried that even that 6.6 is too low and that you're missing some lows, so I can probably see why your endo suggested something higher, for now. There's just a much greater danger with lows in a child her age than complications from highs. There isn't a ton of research out there that definitively proves that lower a1c is always better. At a certain point you have an under 6.8 or so people with diabetes don't necessarily obtain any more benefit. Trying to get into the range of people without diabetes really hasn't proven to be necessary.
     
  18. missmakaliasmomma

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    Yes, that is why I said that I wasn't happy with the 6.6 she just had. She had a lot of lows and her dr didn't even bat an eye. I'm definitely not happy with a 6.6 when there are lows involved. We've been seeing our endo for almost 2 years now and "around 8" is what she's always said. She was actually happy with the 6.6 and I said "did you see all those lows??"
     
  19. missmakaliasmomma

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    I go back and forth with the cgm idea really. I can't come to a concrete decision regarding it.
     
  20. Mish

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    Oh, I just got confused when you said you'd like to be at 6.
     

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