Question of the Week | Why is A1c on the Rise?
RT is 33 years old and has had diabetes for the past 20 years. RT uses an insulin pump and CGM and works hard to keep A1cs less than 7%. Their most recent A1c increased to 7.9% and RT sets up an appointment with the diabetes specialist for help. After downloading the report, the specialist thinks they have discovered the reason behind the increasing A1c.
Which of the following would most likely explain the A1c increase?
- Carbohydrate bolus insulin omissions
- Basal insulin rate set too high
- Bolus insulin given 15 minutes before meal
- CGM sensor malfunction
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Why do the blood sugars keep dropping after meals? Is the basal insulin set correctly? What adjustments are needed for exercise?
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