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Blood Glucose Targets


The Canadian Diabetes Association (CDA) Clinical Practice Guidelines1 recommend the following general guidelines for targets for glycemic control for children and adolescents :

Age
(years)


A1c
(%)


Fasting/Pre-meal
Blood Glucose
(mmol/L)

2-hour Post-meal
Blood Glucose
(mmol/L)

Considerations



<6  <8.5 6.0 – 12.0
-
Extra caution is required to minimize hypoglycemia

6-12
<8.0  4.0 – 10.0 
Targets should be graduated to the child’s age
 
13-18
≤ 7.0
4.0 – 7.0
5.0 – 10.0 
Appropriate for most adolescents
 



The International Society for Pediatric and Adolescent Diabetes (ISPAD) provides similar guidelines for glycemic targets2, although they caution that the targets outlined are intended as guidelines and are based on clinical studies and expert opinion, as “no strict evidence-based recommendations are available” for blood glucose targets. They stress that “each child should have their targets individually determined with the goal of achieving a value as close to normal as possible while avoiding severe hypoglycemia as well as frequent mild to moderate hypoglycemia.” With that in mind, the ISPAD target guidelines for optimal glycemic control (for children and adolescents of all ages) are as follows:

 
Blood Glucose Target (mmol/L)


AM fasting or pre-meal BG
 

5 - 8 

Post-meal
 

5 - 10 

Bedtime
 

6.7 - 10 

Nocturnal (overnight)
 

4.5 - 9 




Your child’s individual goals for blood glucose may differ from the numbers in these charts, depending upon a number of factors, such as: your child’s risk of low blood glucose; whether or not she recognizes a low; how long she has had diabetes; the presence of other medical concerns (related to diabetes or not); and the presence of any other challenges to optimal glycemic control (physical, developmental, psychological, family functioning, presence of others stressors, etc.). Consult with your child’s diabetes health care team to set targets for blood glucose control.




1Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Canadian Journal of Diabetes, 32(1), S151.

2ISPAD Clinical Practice Consensus Guidelines 2006-2007. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatric Diabetes 8, 408-418.



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The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.


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