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Standards of Medical Care in Diabetes for Children

According to the American Diabetes Association



Age
Plasma blood glucose
goal range
(mg/dl)
A1c
(%)
Rationale
Before
meals
Bedtime/
overnight
Toddlers and preschoolers
(0–6 years)
100–180 110–200 <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)
90–180 100–180 <8
•  Vulnerability to hypoglycemia

A lower goal (<7.5%) is reasonable if it can be achieved without excessive hypoglycemia
Adolescents
(13–19 years)
90–130 90–150 <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.
Source: American Diabetes Association
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