Youth with T1 Diabetes Not Meeting A1c Targets: What Can Nurses Do?

By Jeniece Trast, MA, RN, CDE, clinical research nurse manager, certified diabetes educator, Children’s Hospital at Montefiore, Montefiore Medical Center, Bronx, NY

bloodglucosetestingDiabetes Care recently published an article showing that our youth with type 1 diabetes, especially those in adolescence, are not meeting glycosylated hemoglobin (HbA1c) clinical guidelines. The HbA1c is a blood test done every two to three months that shows how well controlled the glucose levels were over that time period. As much as this news is disappointing, I am not shocked by it. Type 1 diabetes is a challenging disease to live with at any age; however, the adolescent years definitely intensify the challenge.

As a nurse and certified diabetes educator (CDE), I take on many roles when caring for a teenager with type 1 diabetes: educator, team member, moderator, blood glucose assessor, advocate, cheerleader, and even role model (yes, I have type 1 diabetes also).

Challenges and responsibilities. When caring for these patients, keep in mind that type 1 diabetes is a difficult disease to live with on a day-to-day basis. People with type 1 have lots of important responsibilities just to stay alive: multiple insulin administrations each day; constant blood glucose checking; understanding the effects of exercise on glucose level both during and after exercise; balancing exercise, stress, food, and insulin; providing sick day care; assessing for and treating hypoglycemia; troubleshooting when things […]