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

摘要

Aims: To evaluate parents' goals and parents' perceptions of physicians' goals for blood glucose and HbA1c 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 HbA1c levels. Results: Children/adolescents had a mean HbA1c 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 HbA1c goal of 42-64 mmol/mol (6-8%). HbA1c was significantly lower when parents reported HbA1c 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 HbA1c goals were tightly linked with parents' perceptions of physicians' blood glucose and HbA1c goals (69% concordant, P 0.0001; 88% concordant, P 0.0001, respectively). Conclusions: There was a significant association between lower parent HbA1c goals and lower child/adolescent HbA1c. 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 Diabetes UK.