Table 16

Plasma blood glucose and A1C goals for type 1 diabetes by age-group

Plasma blood glucose goal range (mg/dl)A1C (%)Rationale
Before mealsBedtime/overnight
Toddlers and preschoolers (0–6 years)100–180110–200<8.5
  • Vulnerability to hypoglycemia

  • Insulin sensitivity

  • Unpredictability in dietary intake and physical activity

  • A lower goal (<8.0%) is reasonable if it can be achieved without excessive hypoglycemia

School age (6–12 years)90–180100–180<8
  • Vulnerability to hypoglycemia

  • A lower goal (<7.5%) is reasonable if it can be achieved without excessive hypoglycemia

Adolescents and young adults (13–19 years)90–13090–150<7.5
  • A lower goal (<7.0%) is reasonable if it can be achieved without excessive hypoglycemia

Key concepts in setting glycemic goals
  • Goals should be individualized and lower goals may be reasonable based on benefit-risk assessment.

  • Blood glucose goals should be modified in children with frequent hypoglycemia or hypoglycemia unawareness.

  • Postprandial blood glucose values should be measured when there is a discrepancy between pre-prandial blood glucose values and A1C levels and to help assess glycemia in those on basal/bolus regimens.