Conference Resources | Abstracts
September 3
rd
– 6
th
, 2014 | Toronto, Canada |
254
P166
ISPAD´s HbA1c targets for children and adolescents are more realistic than ADA´s
R. Hanas
1,2
, K. Lundqvist
1
, L. Windell
1
, A. Sjöstrand
1
1
Uddevalla Hospital, Department of Pediatrics, Uddevalla, Sweden,
2
Gothenburg University,
Sahlgrenska Academy, Gothenburg, Sweden
Background:
ISPAD´s HbA1c targets are lower than ADA´s, and the Swedish are even lower (< 52-
56 mmol/mol (< 6.9-7.3%) in all age groups). Our aim was to look more closely into glycemic control,
side effects and long-term complications in a population-based cohort to see which HbA1c targets that
can be attainable in different age groups.
Methods:
Pumps, glucose meters and continuous glucose monitors were downloaded at a routine
visit. Parents of pen users were asked for details on insulin doses. Data on severe hypoglycemia is
recorded at each visit. Data on complications were taken from medical records. All 84 children and
adolescents below age 18 with diabetes duration >0.5 years at our clinic were included.
Results:
Pump use was 100% in < 7 years, 50% in age 7-12 and 58% in age 13-17, the others used
pens with MDI. See table for results. Two persons had simplex retinopathy (14.3 and 14.9 years
duration), none microalbuminuria.
Conclusions:
Young children have a better metabolic control than teenagers (6.8 vs. 7.6%, p<
0.001). ADA targets seem to be set unrealistically high in the era of intensive treatment 30 years after
DCCT. It is quite possible to achieve HbA1c levels that are well within the ISPAD target of < 7.5% (58
mmol/mol) for all age groups, and still have a low rate of severe hypoglycemia, resulting in low rates of
long-term complications. The lower HbA1c targets of ISPAD and in Sweden have probably contributed
in achieving the reported results.
[Patient characteristics]
