Diabetes Association sets new A1C target for children with type 1 diabetes

June 16, 2014

According to a new position statement released at the Association's 74th Scientific Sessions, the American Diabetes Association is lowering its target recommendation for blood glucose levels for children with type 1 diabetes, to reflect the most current scientific evidence and additionally to harmonize its guidelines with those of the International Society for Pediatric and Adolescent Diabetes (ISPAD).

The Association now recommends that children under the age of 19 diagnosed with strive to maintain an A1C level lower than 7.5 percent. Previously, target – as measured by the A1C, a test that reflects average blood over several months – could be as high as 8.5 percent for children under 6 years of age, 8.0 percent for children 6-12 years of age and 7.5 for adolescents under the Association's guidelines. These targets were set because of concerns over complications caused by , or hypoglycemia.

However, research now shows that prolonged hyperglycemia – levels – can lead to the early development of serious complications in children, such as cardiovascular disease and kidney disease. These complications were once believed to occur only in adults.

"The evidence shows that there is a greater risk of harm from prolonged hyperglycemia that would occur if children maintained an A1C of 8.5 percent over time. This is not to say we are no longer concerned about hypoglycemia, but we now have better tools to monitor for hypoglycemia," said Jane Chiang, MD, Senior Vice President, Medical and Community Affairs, American Diabetes Association and one of the lead authors on the Association's Position Statement. "The 7.5 percent target is evidence-based; however, we want to emphasize that blood glucose and A1C targets must be individualized to safely achieve the best outcomes."

The Association's position statement also emphasizes that type 1 and type 2 diabetes are very different diseases that are treated and managed differently. Recognizing these differences is important to understanding how to better prevent associated complications.

Type 1 diabetes occurs when the body cannot produce enough insulin to convert food into energy. People with type 1 diabetes must take insulin to survive. Although it is most commonly thought of as a disease diagnosed in childhood, the majority of people living with type 1 are adults.

"Type 1 diabetes requires intensive insulin management that differs from how type 2 is managed," said Anne Peters, MD, FACP, Professor, Keck School of Medicine, at the University of Southern California and another of the paper's authors. "People with type 1 require more supplies and must monitor their levels more often. This is not a one-size-fits-all disease, and it's important that we recognize that."

The position statement summarizes data specific to the comprehensive care of people with type 1. Copies of the statement can be found at Diabetes Care.

Related Stories

Blood glucose levels set for achieving HbA1c targets

April 11, 2014

(HealthDay)—The average self-monitored blood glucose (SMBG) concentrations needed at premeal, postmeal, and bedtime have been established to achieve a range of hemoglobin A1c (HbA1c) targets, according to research published ...

Bionic pancreas outperforms insulin pump in adults, youth

June 16, 2014

People with type 1 diabetes who used a bionic pancreas instead of manually monitoring glucose using fingerstick tests and delivering insulin using a pump were more likely to have blood glucose levels consistently within the ...

Recommended for you

Promising progress for new treatment of type 1 diabetes

July 30, 2015

New research from Uppsala University shows promising progress in the use of anti-inflammatory cytokine for treatment of type 1 diabetes. The study, published in the open access journal Scientific Reports, reveals that administration ...

Bacteria may cause type 2 diabetes

June 1, 2015

Bacteria and viruses have an obvious role in causing infectious diseases, but microbes have also been identified as the surprising cause of other illnesses, including cervical cancer (Human papilloma virus) and stomach ulcers ...

'Crosstalk' gives clues to diabetes

June 15, 2015

Sometimes, listening in on a conversation can tell you a lot. For Mark Huising, an assistant professor in the Department of Neurobiology, Physiology and Behavior at the UC Davis College of Biological Sciences, that crosstalk ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.