What should your a1c level be. Understanding A1C Levels: What’s Dangerous and How to Improve Your Results
What is a dangerous level of A1C. How does A1C help diagnose diabetes. What are the different A1C levels. How can you improve your A1C results. What are the risks of high and low A1C levels. How often should you get an A1C test. What factors influence A1C levels.
What is A1C and Why is it Important?
A1C, also known as glycated hemoglobin or HbA1c, is a crucial blood test that provides valuable insights into your average blood glucose levels over the past 2-3 months. This test measures the amount of glucose attached to hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout your body.
Why is A1C so important? It serves two primary purposes:
- Diagnosing diabetes and prediabetes
- Monitoring overall diabetes control in people with existing diabetes
For individuals without diabetes, regular A1C testing can help detect prediabetes or diabetes early, allowing for timely intervention and prevention of complications. For those already diagnosed with diabetes, A1C tests provide a comprehensive picture of blood sugar management, helping healthcare providers adjust treatment plans as needed.
Understanding A1C Levels: What’s Normal, Prediabetic, and Diabetic?
The American Diabetes Association (ADA) has established guidelines for interpreting A1C results:
- Normal (no diabetes): A1C below 5.7%
- Prediabetes: A1C between 5.7% and 6.4%
- Diabetes: A1C of 6.5% or higher
It’s important to note that these are general guidelines, and individual A1C goals may vary based on factors such as age, overall health, and risk of hypoglycemia. For most adults with diabetes, the ADA recommends maintaining an A1C below 7% to help prevent complications. Children with diabetes typically aim for an A1C below 7.5%.
Dangerous A1C Levels: When to Be Concerned
While target A1C levels can vary among individuals, there are certain ranges that are considered potentially dangerous:
High A1C Levels
An A1C consistently above 9% is considered very high and puts individuals at significant risk for diabetes-related complications. These may include:
- Cardiovascular disease
- Kidney damage (nephropathy)
- Eye damage (retinopathy)
- Nerve damage (neuropathy)
- Increased risk of infections
Low A1C Levels
While less common, an A1C below 5% can also be problematic. It may indicate:
- Frequent episodes of hypoglycemia (low blood sugar)
- Increased risk of falls and fractures, especially in older adults
- Potential for cognitive impairment
Is there a specific A1C level that’s universally considered dangerous? While there’s no one-size-fits-all answer, an A1C above 10% or below 4.5% typically warrants immediate attention and consultation with a healthcare provider.
Factors Influencing A1C Results
Several factors can affect A1C results, potentially leading to inaccurate readings:
- Certain medical conditions (e.g., anemia, kidney disease, liver disease)
- Certain medications
- Recent blood transfusions
- Pregnancy
- Genetic factors affecting hemoglobin structure
How can you ensure accurate A1C results? Discuss any health conditions or medications with your healthcare provider before the test. In some cases, alternative methods of assessing glucose control may be recommended.
Improving Your A1C: Strategies for Better Blood Sugar Management
If your A1C is higher than desired, there are several strategies you can employ to bring it into a healthier range:
- Monitor blood glucose regularly: Frequent self-monitoring can help you identify patterns and make necessary adjustments.
- Follow a balanced diet: Focus on whole foods, complex carbohydrates, lean proteins, and healthy fats.
- Exercise regularly: Physical activity helps improve insulin sensitivity and lower blood glucose levels.
- Take medications as prescribed: Adhere to your treatment plan, including insulin or oral medications.
- Manage stress: Chronic stress can elevate blood sugar levels, so find effective stress-reduction techniques.
- Get adequate sleep: Poor sleep can affect glucose metabolism, so aim for 7-9 hours of quality sleep per night.
- Work with a diabetes educator: These professionals can provide personalized guidance on lifestyle modifications and diabetes management techniques.
How long does it take to see improvements in A1C levels? While individual results may vary, many people see significant improvements within 3-6 months of implementing these strategies consistently.
The Role of Technology in A1C Management
Advancements in diabetes technology have revolutionized A1C management:
- Continuous Glucose Monitoring (CGM) systems provide real-time glucose data, allowing for more precise adjustments in diabetes management.
- Insulin pumps, particularly those with closed-loop systems, can help automate insulin delivery for better glucose control.
- Diabetes management apps can track glucose levels, medication doses, diet, and exercise, providing valuable insights for both patients and healthcare providers.
How do these technologies impact A1C levels? Many studies have shown that consistent use of CGM and insulin pumps can lead to significant improvements in A1C levels, often without increasing the risk of hypoglycemia.
A1C Testing Frequency: How Often Should You Get Checked?
The frequency of A1C testing depends on your individual health status:
- For people without diabetes: The CDC recommends A1C testing every 3 years for adults over 45, or earlier for those with risk factors.
- For people with prediabetes: Annual or semi-annual testing is typically recommended.
- For people with well-controlled diabetes: Testing every 6 months may be sufficient.
- For people with diabetes struggling to meet their A1C goals: Quarterly testing is often recommended.
Can A1C be tested at home? Yes, home A1C test kits are available. However, it’s important to discuss the use of these kits with your healthcare provider, as they may be less accurate than laboratory tests.
Beyond A1C: Other Important Diabetes Metrics
While A1C is a valuable tool, it’s not the only metric used to assess diabetes management:
- Time in Range (TIR): This measure, obtained from CGM data, indicates the percentage of time spent within target glucose ranges.
- Glycemic Variability: This refers to the swings in blood glucose levels throughout the day.
- Fasting Plasma Glucose: This test measures blood sugar levels after an 8-hour fast.
- Oral Glucose Tolerance Test (OGTT): This test assesses how well your body processes glucose after consuming a standardized amount.
How do these metrics complement A1C? While A1C provides an average over time, these additional measures offer more detailed insights into day-to-day glucose management, helping to create a more comprehensive picture of overall diabetes control.
Understanding A1C levels is crucial for anyone concerned about diabetes risk or managing existing diabetes. By working closely with healthcare providers, utilizing available technologies, and implementing lifestyle modifications, individuals can strive for optimal A1C levels and reduce the risk of diabetes-related complications. Regular monitoring, coupled with a proactive approach to diabetes management, can lead to improved health outcomes and quality of life.
What Is a Dangerous Level of A1c?
A glycated hemoglobin A1c test (HbA1c), or A1c test for short, is a blood test that tells you your average blood glucose levels over the previous 2-3 months.
This is a standard test that people with diabetes routinely get to assess the overall management of their blood sugar levels and to course-correct treatment plans.
But what is a dangerous level of A1c? This article will investigate A1c levels that are considered both too low and too high, and what to do about improving yours if it is at a dangerous level.
Table of Contents
What is an A1c?
An A1c is a blood test that is typically taken in a laboratory and measures the hemoglobin in your blood.
Hemoglobin is a protein found in your red blood cells and gives blood its red color. It carries oxygen throughout your body and is crucial for good health.
This test measures the average amount of blood glucose attached to the hemoglobin in your red blood cells over the past few months.
Red blood cells regenerate every 3 months, which is why the test will only show your average blood glucose level for the previous 2-3 months.
It is usually skewed toward the preceding several weeks before a test.
What is the importance of an A1c?
An A1c test helps diagnose diabetes
The A1c is an important tool for diagnosing type 1 and type 2 diabetes, prediabetes, and even sometimes gestational diabetes.
If your results reveal prediabetes, your doctor will probably recommend that you get a repeat A1c test done annually or semi-annually. Additionally, for people 45 and older, the Centers for Disease Control and Prevention (CDC) recommend an A1c test every 3 years.
If you have prediabetes, you should talk with your doctor about steps you can take to reduce your risk of developing diabetes.
Your doctor may recommend you get an A1c test if you’re under the age of 45 but have certain risk factors for diabetes, including:
- Being overweight or obese
- Having a family history of diabetes
- Having hypertension (high blood pressure)
- Previously had gestational diabetes
- Are an ethnic minority
- Having heart disease
- Live a sedentary lifestyle/physical inactivity
You should call your doctor right away if you experience the following symptoms, as they are signs of diabetes:
- Extreme thirst
- Frequent urination
- Unexplained weight loss
- Blurry vision/changes in vision
- Extreme hunger
- Fruity-smelling breath
- Lethargy
- Body aches and/or headache
Your doctor may recommend you get an A1c test or seek emergency medical care, depending on the severity of your symptoms.
You can also test your A1c at home with a test kit you can buy at your local pharmacy or online.
An A1c test determines general diabetes control
For people with existing diabetes, a quarterly A1c test is usually ordered to determine your average blood sugar levels, and general diabetes control, over the previous 3 months.
A1c tests are great at detecting if your blood sugars are consistently running high or low, and can help you change your diabetes therapies to help prevent complications such as heart disease, retinopathy, neuropathy, kidney disease, and premature death.
However, since an A1c test is merely an average of your previous 3 months’ blood sugar levels, it will average out all of the high blood sugar levels with all of the low blood sugar levels. This can potentially give you a false sense of accomplishment if, in fact, you’re just riding the blood sugar rollercoaster most days!
If, however, your blood sugar levels are moderately stable, it can give you a great sense of how well you’re managing to keep your blood sugars in range.
What are the different A1c levels?
The American Diabetes Association uses the following definition to determine if you have diabetes or prediabetes:
- Normal, no diabetes: A1c below 5.7%
- Prediabetes: A1c between 5.7% and 6.4%
- Diabetes: A1c of 6.5% or higher
Individual A1c goal levels will vary by person. For example, for someone who doesn’t detect their low blood sugars, or for someone with diabetes who lives alone, their doctor may recommend a slightly higher A1c.
On the other hand, for someone with existing diabetes who is pregnant, an A1c of or below 6% is ideal, as long as they’re not experiencing too many low blood sugars.
American Diabetes Association (ADA) advises A1c levels to stay below 7% to help prevent diabetes complications for adults, and below 7.5% for children.
What is a dangerous A1c level?
There are dangers to having both a too-high and a too-low A1c level.
Always work with your doctor to see what A1c level should be your goal, depending on your lifestyle, health goals, and life stage. However, some dangerous ranges would be best to avoid.
An A1c lower than 5%
While diabetes management is becoming more precise with faster insulins, closed-loop insulin pumps, continuous glucose monitoring (CGM) systems, and better access to diabetes self-management education (DSME), people with diabetes are achieving lower A1cs than ever before.
This is a great accomplishment if you’re not experiencing too many low blood sugars.
Remember, an A1c is just an average blood sugar of the previous three months, so if your A1c is lower than 5%, that may be an indicator that you’re having too many lows.
Even if you’re not experiencing severe low blood sugar that often if you’re older, live alone, have trouble detecting your low blood sugars (have hypo-unawareness), or do not have a continuous glucose monitor (CGM) with low alerts set on, it can be dangerous to have an A1c that low.
A 5% A1c indicates that your average blood sugar is only 97 mg/dL.
This means that even a moderate walk or hot shower could send your blood sugar plummeting at any minute, which can be risky.
Low blood sugars can lead to severe diabetes complications, including diabetic coma and death, so it’s crucial that you prevent severe low blood sugars and have fast-acting glucose or glucagon available in case of an emergency.
If you live alone, are older, have hypo-unawareness, do not have a CGM, or are simply experiencing too many lows, talk with your doctor about lowering your insulin doses to help prevent dangerous lows and increase your A1c.
To note: Pregnant people may have an A1c under 5%, and if they’re not experiencing many low blood sugar levels, this may be fine.
Additionally, at the beginning of a type 1 diabetes diagnosis, many people experience what is known as the “honeymoon phase” where their pancreas is still emitting some insulin, and they may have an extremely low A1c for the first several months to a year after diagnosis.
This is normal, but if you’re in the honeymoon phase with too many low blood sugars, talk with your doctor.
An A1c higher than 7%
While the ADA recommends that most adults maintain an A1c of 7% or lower (and children maintain an A1c of 7.5% or lower), this isn’t always possible.
Competing priorities, money, time, energy, hormones, jobs, school, stress, and everyday life make managing diabetes really hard, and sometimes we struggle with higher-than-ideal blood sugar levels and that is okay!
An A1c is 7% is an average blood sugar level of 154 mg/dL and an A1c 0f 7.5% is an average blood sugar level of 169 mg/dL, both of which are reasonable numbers (especially if you’re a child who is wont to not always finish meals or an adult who struggles to detect dangerous low blood sugars).
Most times, especially during busy or stressful times of life, an A1c of between 7-8% is not dangerous and won’t pose any problems for your health.
An A1c higher than 9%
However, numbers much higher than 9% can start to put you at risk for diabetes complications later on in life.
According to the American Diabetes Association’s Standards of Medical Care in Diabetes, 2022, an A1c of 9% puts one at a higher risk for blindness, heart attack, nerve damage, and kidney failure.
An A1c is 9% is equal to an average blood sugar level of 212 mg/dL.
The higher your A1c, the more dangerous it is and the more likely you are to suffer from diabetes complications.
The following are A1c levels to average blood sugar levels:
10 % = 240 mg/dL
11% = 269 mg/dL
12% = 298 mg/dL
13% = 326 mg/dL
14% = 355 mg/dL
For more detailed information, read How to Translate Your A1c to a Blood Sugar Level.
Prolonged high blood sugars over time can lead to severe diabetes complications, such as retinopathy, neuropathy, heart disease, kidney disease, lower-limb amputations, stroke, and even premature death.
If you’re struggling to lower your A1c, talk to your doctor about increasing or changing your medication regimen, diet, physical activity level, addressing any mental health issues, or if they suggest other ways to help you better manage your blood sugar levels.
To note: at diagnosis, especially with type 1 diabetes, a person will typically have an extremely elevated A1c level.
This does not automatically mean that you will suffer long-term diabetes complications. Usually, after a few months of insulin therapy and treatment, A1c levels drop extremely quickly and there is no risk of serious future complications.
Ways to make your A1c safer
There are ways to both increase and decrease your A1c if you’re falling into the danger zone.
If your A1c is too low
- Work with your doctor to decrease your medications and/or insulin
- Decrease the amount of exercise you do, if you’re struggling with lows after physical activity
- Increase the amount of protein and fat in your diet to help prevent low blood sugars overnight
- If you don’t already have one, use a CGM to catch low blood sugar levels before they become dangerous
- Utilize an insulin pump and use temporary basal settings for things like exercise and other physical activity to help prevent low blood sugars
If your A1c is too high
- Work with your doctor to increase your medications and/or insulin
- Increase the amount of physical activity you do each day
- Eat lower carbohydrate meals and eat plenty of whole foods with fiber
- If you struggle with counting carbohydrates, start a food journal and work with a registered dietitian (RD) to help you meal plan
- Avoid processed foods and foods and drinks with added sugar
- Check your blood sugar multiple times a day, or utilize a CGM to help catch high blood sugars sooner
- Utilize an insulin pump that can use different basal rates throughout the day and night to help prevent prolonged high blood sugars
- Get plenty of sleep (aim for between 7-9 hours per night for better insulin sensitivity)
- Manage stress with yoga, meditation, and breathing to decrease insulin resistance
Summary
While there is a lot of talk about the dangers of a high A1c, there isn’t much talk about the dangers of a low A1c, and there is a lot of confusion as to what is actually dangerous and what to do about it.
For most people, a good and safe A1c lies anywhere between 5-8%, although this will vary from person to person.
If you’re pregnant, your A1c should be lower, and if you live alone or struggle with low blood sugars, your doctor may want your A1c on the higher end.
However, an A1c that is routinely under 5% can pose a danger of too many and too severe low blood sugars, which can cause diabetic coma and death.
An A1c of 9% or above increases your risk for diabetes complications, including heart disease and heart attack, stroke, retinopathy and blindness, nerve damage and amputation, kidney disease and kidney failure, and ultimately, premature death.
Work with your doctor to adjust your medications, increase or decrease your physical activity, alter your diet, and better regulate sleep and stress to help you land your goal A1c.
While there is no “perfect” A1c, no one should have to live with an A1c at a dangerous level that is harmful to one’s health and well-being.
Test, levels, and more for diabetes
The A1C test is a blood test that measures a person’s average blood glucose or blood sugar levels over the past 3 months. An A1C reading of over 5.7% may be a cause for concern, but this will depend on various factors.
Doctors use the A1C test to check for prediabetes and diabetes. A range of 5.7–6.5% suggests a person may have prediabetes. Over 6.5% indicates diabetes.
This test also helps doctors monitor blood glucose levels in people with diagnosed diabetes.
Keeping A1C levels within the normal or target range lowers the risk of developing diabetes or its complications. Read on to learn what A1C test results mean.
The A1C chart below can help a person convert and understand their A1C test results. The doctor can provide more context and describe ways to keep blood glucose levels in a safe range.
Share on PinterestMNT-infographic_guide illustration by Diego Sabogal a1c-chart
The A1C test is also known as the:
- hemoglobin A1C, or HbA1c, test
- glycated hemoglobin test
- glycohemoglobin test
The A1C test measures the percentage of red blood cells that have glucose-coated hemoglobin.
This measurement gives doctors an idea of the person’s average blood glucose levels over the past 2–3 months.
Hemoglobin is an iron-rich protein in red blood cells. It helps carry oxygen from the lungs to other tissues.
When glucose enters the blood, it binds to hemoglobin. The more glucose in a person’s bloodstream, the more hemoglobin is bound to glucose.
Undergoing the A1C test is straightforward: A healthcare professional takes a blood sample and sends it to a laboratory for testing.
A doctor may order this test to:
- diagnose prediabetes
- diagnose type 1 or type 2 diabetes
- monitor the blood glucose levels of a person with diabetes to check how well their treatment is working
If a person takes insulin to manage diabetes, their doctor may also ask them to monitor their blood glucose levels at home with a blood glucose meter or continuous glucose monitor.
In this case, the person still needs to undergo regular A1C testing.
Traditionally, A1C levels are reported as a percentage. Alternately, they may be reported as estimated average glucose (eAG), in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).
Blood glucose meters and continuous glucose monitors also give eAG readings, some from at least 12 days of data.
The A1C test gives a more accurate long-term average. It takes into account fluctuations throughout the day, such as overnight and after meals.
A normal A1C level is below 5.7%. Normal eAG is below 117 mg/dL or 6.5 mmol/L.
If someone’s A1C levels are higher than normal, they may have diabetes or prediabetes. Their doctor might order a repeat test to confirm this.
Target levels in people with diabetes
A doctor will set a person’s target A1C level based on many factors. The right target varies from person to person.
For someone with diabetes, the target A1C level may depend on:
- the person’s age
- their overall health
- whether they are pregnant
- how long they have had diabetes
- their prescribed treatment plan
- any history of adverse effects from the treatment, including episodes of low blood glucose, or hypoglycemia
- any complications from diabetes
- the person’s preferences and treatment priorities
In general, a doctor might recommend aiming for A1C levels under 6.
5% if a person:
- is young and has a long life expectancy
- has had diabetes for a short period
- is effectively managing their diabetes with lifestyle changes or metformin alone
- is otherwise in good health
A doctor might recommend A1C targets of 7.0–8.5% if a person:
- is older and has a shorter life expectancy
- has had diabetes for a longer period
- has diabetes that is hard to manage, even with multiple medications
- has a history of severe hypoglycemia or other adverse effects of treatment
- has experienced complications of diabetes
- has other chronic health conditions
A person should work with their doctor to reassess and adjust their A1C targets over time. The condition and treatment goals may change.
To screen for diabetes, a doctor may order an A1C test for someone older than 45. They may also do this for younger people who have other risk factors.
After diagnosing diabetes, a doctor determines how often to test A1C levels.
If a person is meeting their treatment goals, they may need an A1C test twice a year. When managing blood glucose levels is challenging, a person tends to need this test more frequently.
A person should make an appointment with their doctor if they:
- have questions or concerns about their treatment plan
- are finding it hard to keep their blood glucose levels within the target range
- have had symptoms of high or low blood glucose levels
- think they might have complications of diabetes
Symptoms of high blood glucose levels include:
- fatigue
- unusual thirst
- frequent urination
- blurred vision
Symptoms of low blood glucose levels include:
- nervousness, irritability, or anxiety
- confusion
- dizziness
- hunger
- shaking
- sweating
Anyone who develops any of the symptoms above or notices other changes in their health should let their doctor know.
A doctor orders an A1C test to check whether someone has prediabetes or type 1 or 2 diabetes. Doctors also use this test to monitor blood glucose levels in people with diabetes to see how well their treatment plan is working.
A1C test results are usually a percentage, but they may come as an eAG measurement. Target A1C levels vary from person to person, depending on age, overall health, and other factors.
Having high A1C levels may indicate that the person has diabetes or a high risk of related complications. In this case, the doctor will work with the person to adjust the approach to treatment.
Blood test for glycated hemoglobin A1c
Glycated (or glycosylated) hemoglobin A1c reflects the sugar level over the previous 2-3 months. A test for its amount is one of the markers for the presence of diabetes. Its results are used both for diagnosing the disease and for monitoring its course, monitoring the effectiveness of treatment. The test gives the attending physician the opportunity to identify violations of carbon metabolism, to choose the best therapy.
General
Hemoglobin in erythrocytes is a protein whose main task is to transport oxygen. Among all the varieties of this protein, the A form predominates. One of its components is called A1c. Glucose in the bloodstream is able to spontaneously combine with hemoglobin. The resulting compound is glycated or glycosylated hemoglobin. Its formation directly depends on the amount of sugar. The compound remains stable throughout the life cycle of the erythrocyte. It is formed and broken down daily along with the renewal of red blood cells.
For patients with diabetes, controlling glucose levels and maintaining them at an optimal level makes it possible to avoid the development of complications that can lead to disability and death. Passing this test during a preventive examination makes it possible to detect diabetes in a timely manner.
The characteristic symptoms of diabetes include a constant feeling of thirst, weakness, decreased vision, frequent urination, and a high susceptibility to infectious diseases.
If they appear, you should immediately consult a doctor, undergo an examination, and upon confirmation of the diagnosis, begin treatment.
Indications for examination
Patients with diagnosed diabetes are examined every four months (if necessary, more often, the frequency of a blood test for glycated hemoglobin HbA1c is selected by the doctor on an individual basis). Also, the study is prescribed for pregnant women and patients with suspected diabetes for its primary diagnosis. In the absence of health complaints, it is recommended to take the test during a preventive examination at least once every three years. If there is a history of significant bleeding or hemolysis, false results may be obtained. In such cases, it is recommended to consult a doctor before taking the test. If necessary, he will recommend an alternative analysis or this test will be carried out at a later date.
Study preparation
Blood for analysis must be taken strictly on an empty stomach.
There is no need to observe a long hungry pause, it is enough not to eat food for three hours before the study. During this period of time, you can drink only sparkling water.
Interpretation of results
Reference values are 4.8 – 5.9%. An increase in readings may indicate diabetes or a pre-diabetic condition. With iron deficiency or after a blood transfusion, the indicators may increase. For a competent interpretation of the results, it is necessary to consult a doctor. Only a specialist can make the correct diagnosis and, if necessary, prescribe treatment.
Glycated hemoglobin: price of analysis
The cost of this test is higher than a standard sugar test. For the most accurate diagnosis, it is recommended to undergo a study on A1c. The test determines the average sugar level for 3 months. Therefore, external factors (for example, stress) do not significantly affect the result. A single test for sugar in this case is less accurate, often it has to be repeated several times.
If your child’s doctor suspects type 2 diabetes, they may recommend a screening test. To diagnose diabetes in children, use:
If the results of a random blood sugar test do not indicate diabetes, but the doctor suspects it, other tests may be ordered:
After diagnosis Other Periodic Tests | Treatment for type 2 diabetes involves lifelong blood sugar control, a healthy diet, regular exercise, and sometimes the use of insulin or other drugs, even for children. As the child grows, the treatment plan will change. If managing your child’s diabetes seems like a daunting task, act here and now and remember that you are not alone.  You will work closely with your child’s diabetes care team, which includes a doctor and dietitian, to keep your child’s blood sugar levels as close to normal as possible. Blood sugar monitoring Depending on what type of medication your child is taking (if any), you may need to check your blood sugar several times a day. To do this, a skin puncture is performed with a scarifier at the tip of the finger, although other parts of the body are sometimes involved. Children who need insulin therapy should check their blood sugar levels at least three times a day. Ask your doctor how often your child should have their blood sugar checked. Using a glucometer is the only way to make sure your baby’s blood sugar stays within the target range, which can change as the baby grows. What is the target range for your child, the doctor will tell you. He may also ask you to keep a diary of your child’s blood glucose readings, or he may download this information from your meter.  Even if your child eats on a regular schedule, their blood sugar levels can fluctuate unpredictably. With the help of your child’s diabetes management team, you will learn how your child’s blood sugar changes occur in response to:
Healthy eating Physical activity Medication
Because stomach enzymes break down insulin taken by mouth, insulin is not taken by mouth but injected under the skin. Insulin delivery options include:
There are different types of insulin, including fast-acting, long-acting, and intermediate options. The decision on which treatment is best depends on the child, their blood sugar levels, and whether they have any other health problems. Initially, children whose blood sugar level exceeds 250 mg/dl (13.9mmol/L) or who have an HbA1c above 9% are likely to start insulin therapy to stabilize their blood sugar levels. Once your blood sugar returns to normal, your child can be switched from insulin to metformin. Signs of problems Low blood sugar (hypoglycemia) Watch for the following symptoms:
Treatment for low blood sugar High blood sugar (hyperglycemia) Watch for the following symptoms:
Treating hyperglycemia Diabetic ketoacidosis Watch for the following:
Treatment for ketoacidosis |
The higher your blood sugar level, the higher the level of glycated hemoglobin. An HbA1c level of 6.5% or higher in two separate tests means you have diabetes. Results of 5.7 to 6.4% are considered prediabetes, indicating a high risk of developing diabetes.
Reading from 140 to 199 mg/dl (7.8 to 11 mmol/l) indicates prediabetes.
An HbA1c of 7% corresponds to an estimated mean glucose of 154 mg/dL (8.6 mmol/L). 
He should also limit carbonated drinks, juices, sweets and eat less foods containing animal fats. This type of food is usually the most suitable for the whole family. Even sugary foods can be included in a child’s meal plan from time to time. 
Play ball in the yard. Walk or run around the area. Visit an indoor climbing wall or a local swimming pool. Make physical activity a part of your child’s daily routine. 
It consists of a so-called hearth, in which there is a reservoir with insulin and a miniature catheter for injecting insulin under the skin, and a control panel. The under can be worn on the abdomen, lower back, or on the leg or arm. The hearth is controlled by a remote control.
Long-acting insulin, such as insulin glargine (Lantus), is often used to treat type 2 diabetes in children.
If blood sugar remains low, give your child another sweet food and test again in 15 minutes. 
You may need to adjust your child’s diet or treatment plan. If your child’s blood sugar is consistently above the target range set by the doctor, call the doctor right away or seek emergency medical attention.