Commercials for pantyhose or perhaps the turning radius of that fancy car you always dreamed of owning?
No, tight control, in this case, means keeping your blood glucose levels within a limited range. Specifically it means maintaining period A1c readings at around 7% for an extended period.
What is an A1c test and what does it tell me about my child’s type one Diabetes?
An A1c test or HbA1c test is a blood test that measures the amount of glycohemoglobin in the blood. Glycohemoglobin is the protein that forms when hemoglobin (the blood protein that carries oxygen) binds with glucose. In a person who doesn’t have diabetes, glycohemoglobin levels are around 5 to 6% of the total hemoglobin in the blood. The more glucose there is in the blood, the higher the level of glycohemoglobin in the blood. Someone with juvenile diabetes who has higher than normal levels of glucose in the blood will have more glycohemoglobin in their blood.
The hemoglobin in your blood remains in circulation for 60 to 90 days. The amount of glycohemoglobin in your blood represents the average amount glucose in the blood over the last 2 to 3 months. The A1c test gives your medical team a pretty good measure of where you child’s blood sugars have been over the last 2 or 3 months.
If a person’s A1c test is 7%, that means that their average blood glucose levels have been at 150 mg/dL. It the reading is 8% that means that their blood glucose levels have averaged to around 180 mg/dL. Anything higher than this and the team will probably review their treatment regimen.
A high reading on this test doesn’t mean that parents aren’t keeping a close eye on their child’s diabetes. Generally it means that there needs to be a change in insulin, probably because your child has grown.
Should you try to keep “tight control” of juvenile diabetes?
Keeping tight control with children is difficult because there are many variables that are affecting their blood sugar levels, like the fact that they are growing. However, the goal of tight control can help you to instill some good habits that will help your child in the future.
Regular mealtimes and blood glucose tests
Making sure your child eats three meals with a balance of proteins, carbohydrates and fats is key to good regulation. If it is possible, keep grazing to a minimum but instead provide timely snacks, keeping 3 hours between eating. To stave off over night low, have your child eat protein, like peanut butter crackers and milk before bed.
Review blood sugar and insulin doses to see patterns.
Keep a log of activities, carb intake and insulin dosages. If you miss, don’t fret because blood glucose meters and insulin pumps have memory functions. Review you log and try to figure out your child’s patterns.
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Look at the ratio of basal insulin to bolus insulin
Basal insulin should be at least 40% of the insulin your child receives in a day. Generally it should not be more that 50%. If it is less than 40% or more than 50% your child’s blood sugar readings are not stable.
You can’t imitate a healthy pancreas perfectly
So don’t go crazy over this. Part of your job as a parent of a child with type one diabetes is loving your child. Moderation is key. Overdoing and obsessing over blood sugar readings and carbs counts to the exclusion of fun and love does nothing but alienate your child.