Hgb A1c every 3 months?

Hello, I am a mom to a newly diagnosed Type 1 child. She was diagnosed at 22 months (8 months ago). I think that this forum is going to be really good for me, I feel like I am needing support more than ever. We live in a city with few options as far as Pediatric Endocrinology goes. My question is about the hgb A1c…our doc wants it drawn every 3 months which seems a little much for a 2 year old. It is absolute torture watching them draw her blood. We do have a Dexcom G6, no pump yet, still using diluted insulin. Is it unreasonable to ask to have the blood draws be done further apart? Can someone explain what might change based on the results? We are constantly doing insulin and carb ratio adjustments as it is. Thank you so much everyone!

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Hello @abbysmom1221 Kristin and welcome to TypeOneNation. I have type 1 and I’ve had it about 40 years

We’re glad you are here!

The doctor is using a1c as a general “how we doing “ score which can, in my opinion, be reduced as long as you are sharing the DEX data.

Have the conversation with the doctor. Talk it out. Diabetes is unpleasant and painful. I believe your instincts are good. I would say the same thing.

Cheers welcome to the forum

Hi Kristin @abbysmom1221, I feel for you, and for Abby needing blood draws when not absolutely necessary. It feels as if it has been forever that I’ve had an HbA1c every three months - it is possibly the best single guide-post, or as @Joe said “score” for knowing progress in diabetes management.
But in my opinion, given that your daughter regularly, and I assume constantly, wears a Dexcom G6, the lab-test A1c could be spaced further apart.
The Clarity reports have recently been expanded by Dexcom to include what is called " Glucose Management Indicator " [GMI]which is a calculated estimate of A1c based on the 288 daily CGM readings. The GMI appears on the Overview page of Clarity; I have compared my A1c lab report with a compatible 90 period on Clarity and find it fairly accurate - within 0.2%. Use this bit of information for an “argument” to reduce the frequency for Abby’s blood draw.

hi @abbysmom1221 do you know about EMLA cream to numb the skin for bloodwork? Any pharmacy should carry it. Hope this helps.

In my son’s endo’s office the A1c test is a simple finger poke. Do they not have that option? We only do actual blood draws once per year to test for things like thyroid disease etc…

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I feel for where you are coming from. As moms we only want to protect our children from harm. Bad enough with all the needles and lancing for BG testing multiple times a day.
Not sure if your insurance is like mine. But mine requires an Endocrinologist visit and A1C every 3 months. In order to continue coverage for my cgm. This could be a possible reason your Dr wants it done. I would ask if there is any specific reason as such.

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With you sister - T1D for 32 years and a A1C blood draw every three months for a frightened child is a bit extreme… Lots of other options in these comments - ask your Doc to pick one…!!!

I know when I saw a peditraic endo they were able to do the A1C from a finger stick and not have to do a formal from arm draw. I have always had a formal 3 month A1C done the last 15 years so I’m assuming it’s just standard. Worth asking about though!

I also have a very young child with T1D (16 months old). We test A1C every three months but with just a simple finger prick. You may ask if that is an option.

Thank you everyone for all of your support and replies. We had a visit with our Endocrinologist and she expressed that she did not like using the GMI data from the CGM as a replacement for a Hgb A1C. She said that we could check it every 4 months but that was the longest she would go. Apparently the office had ordered a finger stick machine but received the wrong one and is having trouble getting it now. The doctor did say I could purchase my own finger stick machine. The worst thing is that at the end of the visit the doctor actually entered the GMI number into the chart herself as a Hgb A1C result, even though she made it a point to tell me it was not accurate. I only wish I could get consistent information. I think I will consider getting my own A1C finger stick monitor. I apologize if I seem to be complaining, I just want the very best for my daughter with the least amount of pain.

Thank you Kristin @abbysmom1221 for this update.
For accuracy, there really isn’t anything more accurate than as good as the lab result using blood drawn fro a vein [rather than capillary blood]. I’ve only had two finger-stick A1c and found that they were off considerably from lab test results of blood drawn within a couple of days of the finger-stick checks; the lab test results were higher - 6.4% as opposed to 5.6% with capillary. The GMI calculates higher but with less of a difference.

I hope that Abby is making good progress!!!