Table 12.1

Blood glucose and A1C goals for children and adolescents with type 1 diabetes

Blood glucose goal rangeA1CRationale
Before mealsBedtime/overnight
90–130 mg/dL (5.0–7.2 mmol/L)90–150 mg/dL (5.0–8.3 mmol/L)<7.5% (58 mmol/mol)A lower goal (<7.0% [53 mmol/mol]) 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 a 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 preprandial blood glucose values and A1C levels and to assess preprandial insulin doses in those on basal-bolus or pump regimens.