The impact of blood glucose and HbA1c goals on glycaemic control in children and adolescents with Type 1 diabetes

Abstract

To evaluate parents' goals and parents' perceptions of physicians' goals for blood glucose and HbA(1c) in children and adolescents with Type 1 diabetes. In a cross-sectional observational assessment, parents (80% mothers) of 153 children/adolescents (56% female), aged 12.9±2.3years (range 8-16years) with Type 1 diabetes for 6.3±3.5years, completed surveys regarding their goals and their perceptions of physicians' goals for their child's blood glucose and HbA(1c) levels. Children/adolescents had a mean HbA(1c) of 69±16mmol/mol (8.4±1.4%) and checked blood glucose levels 3.8±1.2times/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 42-64mmol/mol (6-8%). HbA(1c) was significantly lower when parents reported HbA(1c) goals ≤64mmol/mol (≤8%) vs. >64mmol/mol (>8%) [67±14mmol/mol (8.3±1.2%) vs. 76±20mmol/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). 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.