From Cairo, Egypt:
My 14 year old son has had type 1 since February 2000. He has been using a pump since last December. We have had a hard time adjusting his basal and bolus rates since his blood sugar seems to fluctuate so much every day. He used the CGMS several times, but he is still having problems. His last A1c was 9.0, which I know is very high. Is this normal with puberty or are we just not able to adjust his pump properly?
Even during puberty, one of the most difficult periods of "metabolic" life for a young patient with type 1 diabetes, an A1c level as high as 9.0% is too high. Every effort should be made to reach a much lower value towards the 6.5% American Diabetes Association cutoff. I strongly suggest you ask for a referral for a diabetes team with a longer experience with pumps, if necessary, outside your own country, e.g. in Europe.
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