The impact of blood glucose and HbA1c goals on glycaemic control in children and adolescents with Type 1 diabetes. Issue 3 (20th February 2013)

• Record Type: Journal Article
• Authors: Boot, M.; Volkening, L. K.; Butler, D. A.; Laffel, L. M. B.
• Is Part Of: Diabetic medicine. Volume 30:Issue 3(2013:Mar.)
• Page Start: 333
• Page End: 337
• Publication Date: 2013-02-20
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12083
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" xml:lang="en" id="dme12083-abs-0001"> <title>Abstract</title> <sec id="dme12083-sec-0001" sec-type="section"> <title>Aims</title> <p>To evaluate parents' goals and parents' perceptions of physicians' goals for blood glucose and HbA<sub>1c</sub> in children and adolescents with Type 1 diabetes.</p> </sec> <sec id="dme12083-sec-0002" sec-type="section"> <title>Methods</title> <p>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<sub>1c</sub> levels.</p> </sec> <sec id="dme12083-sec-0003" sec-type="section"> <title>Results</title> <p>Children/adolescents had a mean HbA<sub>1c</sub> 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<sub>1c</sub> goal of 42–64 mmol/mol (6–8%). HbA<sub>1c</sub> was significantly lower when parents reported HbA<sub>1c</sub> goals ≤ 64 mmol/mol (≤ 8%) <italic>vs</italic>. > 64 mmol/mol (> 8%) [67 ± 14 mmol/mol (8.3 ± 1.2%) <italic>vs</italic>. 76 ± 20 mmol/mol (9.1 ± 1.8%), respectively, <italic>P </italic>= 0.02]. Parents' blood glucose and HbA<sub>1c</sub> goals were tightly linked with parents' perceptions of physicians' blood glucose and HbA<sub>1c</sub> goals (69% concordant, <italic>P</italic> < 0.0001; 88% concordant, <italic>P</italic> < 0.0001, respectively).</p> </sec> <sec id="dme12083-sec-0004" sec-type="section"> <title>Conclusions</title> <p>There was a significant association between lower parent HbA<sub>1c</sub> goals and lower child/adolescent HbA<sub>1c</sub>. 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.</p> </sec> </abstract>