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

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 +/- 2.3years (range 816years) 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 HbA1c levels. Results Children/adolescents had a mean HbA1c 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 (80180)mg/dl [7.2 (4.410)mmol/l]; 75% of parents reported a HbA1c goal of 4264mmol/mol (68%). HbA1c was significantly lower when parents reported HbA1c 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 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.