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UNDERSTANDING ROUTINE TESTING All Routine Testing Is Based on Current American Diabetes Association Standards of Medical Care for Diabetes

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UNDERSTANDING ROUTINE TESTING All Routine Testing Is Based on Current American Diabetes Association Standards of Medical Care for Diabetes CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND UNDERSTANDING ROUTINE TESTING All routine testing is based on current American Diabetes Association Standards of Medical Care for Diabetes GROWTH AND HEMOGLOBIN A1c THYROID FUNCTION WEIGHT GAIN TESTS (T4, TSH) When your child’s This blood test is the measurement that gives us a Children with diabetes are diabetes is in control, your general picture of the overall control of diabetes more susceptible to thyroid child should grow and over the last 3 months. problems. gain weight at a normal • This test is very important and should be done Some of the symptoms of rate (following the growth every 3 months. thyroid problems are: curve in our chart). • The result is a percentage, and the closer to your » Abnormally slow growth • We measure your child’s child’s appropriate target, the better the control. » Excessive fatigue (tired height and weight at • This test gives us an idea (combined with the all the time) each clinic visit. blood glucose meter download) of what the blood » Extra dry skin sugars are between checks. » Loss of hair • The Diabetes Control and Complications Trial • These tests will be showed a huge decrease in complications if the performed every year. A1c is kept at or close to the target level. The following test 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 CHOLESTEROL TEST URINE EYE PANEL (TTg) (LIPID PROFILE) MICROALBUMIN EXAMS Children with diabetes may be High levels of cholesterol High blood sugar High blood sugars at risk for celiac disease/gluten can contribute to heart concentrations over a over time can also intolerance. disease. High blood sugars long period of time can damage the tiny • Some symptoms are: contribute to higher LDL cause a thickening of blood vessels of » Poor growth and triglyceride levels. the membranes of the the eyes. » Stomach pains • Lipid panels screen high- kidneys. When they • An » Diarrhea density lipid levels (HDL start to get this damage, ophthalmologist protein leaks into the • Celiac disease is an or “good” cholesterol), (eye doctor) urine. autoimmune process low density lipids (LDL dilates the pupils triggered by gluten, causing or “bad” cholesterol), • This screening to look at the the immune system to destroy and triglycerides. monitors for early signs blood vessels. the body’s intestinal villi. of kidney problems. ENDOCRINOLOGYPEDIATRIC NEUROLOGY/DIABETES TEAM - (510) CENTER 428-3590 747 52nd St., Oakland, CA 94609 510-428-3654 www.childrenshospitaloakland.org © 2012 CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND HEMOGLOBIN A1c/ GLYCATED HEMOGLOBIN WHAT IS THE A1c? FORMULA: • The A1c measures how much glucose (sugar) has attached BG (mg/dL) = (A1c% x 28.7) - 46.7 to the red blood cells (hemoglobin). Average blood glucose A1c% • Once the sugar is attached to the hemoglobin, it stays (mg/dl) there for the life of the red blood cell, which is approximately 3 months. 5 97 • The higher the level of blood sugar, the more sugar attaches 5.5 111 to the red blood cell causing the A1c value to increase. 6.0 125 • The more sugar that attaches to the hemoglobin the higher the percent of hemoglobin which is glycosylated which is 6.5 140 why the A1c is given as a percentage. 7.0 154 7.5 168 red blood cell sugar 8.0 183 8.5 197 9.0 212 9.5 226 Low A1c High A1c 10.0 240 WHY MEASURE THE A1c? 10.5 255 The A1c test assesses blood sugar control over time by giving 11.0 269 an “average” blood sugar from the past 3 months. 11.5 283 The combination of the A1c and daily blood sugar monitoring levels indicate overall diabetes control. 12.0 298 12.5 312 WHY IS IT IMPORTANT TO CONTROL THE BLOOD SUGAR AND A1c? 13.0 326 Controlling the blood sugar will help you feel better. 13.5 341 Maintaining A1c levels within the goal range dramatically reduces the risk of complications. 14.0 355 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% ENDOCRINOLOGYPEDIATRIC NEUROLOGY/DIABETES TEAM - (510) CENTER 428-3590 747 52nd St., Oakland, CA 94609 510-428-3654 www.childrenshospitaloakland.org © 2012 CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND.
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