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Diabet Med. 2013 Mar;30(3):333-7. doi: 10.1111/dme.12083.

The impact of blood glucose and HbA(1c) goals on glycaemic control in children and adolescents with Type 1 diabetes.

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  • 1Pediatric, Adolescent and Young Adult Section, Genetics & Epidemiology Section, Joslin Diabetes Center, Boston, MA, USA.

Abstract

AIMS:

To evaluate parents' goals and parents' perceptions of physicians' goals for blood glucose and HbA(1c) in children and adolescents with Type 1 diabetes.

METHODS:

In a cross-sectional observational assessment, parents (80% mothers) of 153 children/adolescents (56% female), aged 12.9 ± 2.3 years (range 8-16 years) with Type 1 diabetes for 6.3 ± 3.5 years, completed surveys regarding their goals and their perceptions of physicians' goals for their child's blood glucose and HbA(1c) levels.

RESULTS:

Children/adolescents had a mean HbA(1c) of 69 ± 16 mmol/mol (8.4 ± 1.4%) and checked blood glucose levels 3.8 ± 1.2 times/day; 23% received pump therapy. Almost half of parents reported a blood glucose goal of 130 (80-180) mg/dl [7.2 (4.4-10) mmol/l]; 75% of parents reported a HbA(1c) goal of 42-64 mmol/mol (6-8%). HbA(1c) was significantly lower when parents reported HbA(1c) goals ≤ 64 mmol/mol (≤ 8%) vs. > 64 mmol/mol (> 8%) [67 ± 14 mmol/mol (8.3 ± 1.2%) vs. 76 ± 20 mmol/mol (9.1 ± 1.8%), respectively, P = 0.02]. Parents' blood glucose and HbA(1c) goals were tightly linked with parents' perceptions of physicians' blood glucose and HbA(1c) goals (69% concordant, P < 0.0001; 88% concordant, P < 0.0001, respectively).

CONCLUSIONS:

There was a significant association between lower parent HbA(1c) goals and lower child/adolescent HbA(1c) . Further, parents appear to set glycaemic goals based upon their perceptions of physician goals. Future studies should assess the relationship between parents' perceptions of health-care providers' goals and health-care providers' actual goals and the impact of unified family/provider goal-setting on glycaemic control.

© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

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