All routine testing is based on current American Diabetes Association standards of medical care for diabetes.

Growth and Weight Gain

When your child’s diabetes is in control, your child should grow and gain weight at a normal rate. We record your child’s height and weight at each clinic visit.

Hemoglobin A1c

This blood test is the measurement that gives us a general picture of the overall control of diabetes over the last 3 months.

  • This test is very important and should be done every 3 months.
  • The result is a percentage, and the closer to your child’s appropriate target, the better the control.
  • This test gives us an idea (combined with the blood glucose meter download) of what the blood sugars are between checks.
  • The Diabetes Control and Complications Trial showed a huge decrease in complications if the A1c is kept at or close to the target level.

Thyroid Function Tests (T4, TSH)

Children with diabetes are more susceptible to thyroid problems.

Some of the symptoms of thyroid problems are:

  • Abnormally slow growth
  • Excessive fatigue (tired all the time)
  • Extra dry skin
  • Loss of hair

Thyroid function tests will be performed every year.

The following tests are done based on age of child, length of time the child has had diabetes, and family risk factors. The goal of screening tests is to prevent complications.

Celiac Panel (TTG)

Children with diabetes may be at risk for celiac disease/gluten intolerance.

Some symptoms are:

  • Poor growth
  • Stomach pains
  • Diarrhea

Celiac disease is an autoimmune process triggered by gluten, causing the immune system to destroy the body’s intestinal villi.

Cholesterol Test (Lipid Profile)

High levels of cholesterol can contribute to heart disease. High blood sugars contribute to higher LDL and triglyceride levels.

  • Lipid panels screen high-density lipid levels (HDL or “good” cholesterol), low density lipids (LDL or “bad” cholesterol), and triglycerides.

Urine Microalbumin

High blood sugar concentrations over a long period of time can cause a thickening of the membranes of the kidneys. When they start to get this damage, protein leaks into the urine. This screening monitors for early signs of kidney problems.

Eye Exams

High blood sugars over time can also damage the tiny blood vessels of the eyes. An ophthalmologist (eye doctor) dilates the pupils to look at the blood vessels.

Hemoglobin A1c/Glycated Hemoglobin

What Is The A1c?

  • The A1c measures how much glucose (sugar) has attached
  • to the red blood cells (hemoglobin).
  • Once the sugar is attached to the hemoglobin, it stays
  • there for the life of the red blood cell, which is approximately 3 months.
  • The higher the level of blood sugar, the more sugar attaches to the red blood cell causing the A1c value to increase.
  • The more sugar that attaches to the hemoglobin the higher the percent of hemoglobin which is glycosylated which is why the A1c is given as a percentage.

Why Measure The A1c?

The A1c test assesses blood sugar control over time by giving an “average” blood sugar from the past 3 months. The combination of the A1c and daily blood sugar monitoring levels indicate overall diabetes control.

Why Is It Important To Control The Blood Sugar and A1c?

Controlling the blood sugar will help you feel better. Maintaining A1c levels within the goal range dramatically reduces the risk of complications.

The American Diabetes Association Has Set Age Appropriate Targets for Hba1c as Follows:

Child’s age (years)

Blood glucose goal range

A1c
Toddlers/Preschoolers (0-6 years)  100-200 Under 8.5% (but over 7.5%)
School Age (6-12 years)  90-180 Under 8%
Adolescents/Young Adults (13-19 years)   90-150 Under 7.5%
 Adults  80-150 Under 7%

Formula: Bg (Mg/Dl) = (A1c% X 28.7) - 46.7

A1c%

Average blood glucose (mg/dl)

  

A1c%

Average blood glucose (mg/dl)
5 97   10.0  240
5.5 111   10.5  255
6.0 125   11.0  269
6.5 140   11.5  283
7.0 154   12.0  298
7.5 168    12.5  312
8.0 183    13.0  326
8.5 197    13.5  326
9.0 212    14.0  355
9.5 226