One of the goals in managing type 1 diabetes is reducing fluctuations in blood glucose levels. Maintaining a stable blood sugar is ideal, which means consistently monitoring glucose levels and administering appropriate insulin doses.
The target range for HbA1C levels in children has typically been 7.5% or below. This was meant to keep blood sugar low enough to reduce the risk of organ and tissue damage but high enough to help curb hypoglycemia concerns. However, a recent report reveals that maintaining an HbA1C level of 7.0% or below may be better for short- and long-term health outcomes for children with type 1 diabetes (T1D).
Studies have shown that abnormal brain development, heart problems, diabetes-related complications, and mortality in children and adolescents may be at increased risk when blood sugar levels remain elevated. Tighter control and a lower target range may be beneficial in reducing both acute and long-term effects.
Although lower HbA1C levels were previously thought to increase the risk of hypoglycemia, several studies have shown the number of incidences has declined over the past three decades, and “the link between lower glucose targets and hypoglycemia risk has weakened over the past 15 years.”
The use of continuous glucose monitors and insulin pumps as part of T1D management and insulin analogs have played an integral role in allowing patients and caregivers to maintain tighter control over A1C levels and minimize fluctuations in blood sugar levels.
While an HbA1C level of 7.0% or below is now recommended for many children with T1D, those patients who are unaware of hypoglycemia symptoms cannot adequately articulate them, a target of 7.5% is still recommended. There are also exceptions for those patients with a history of severe hypoglycemia and those with other pre-existing conditions or comorbidities. Patients with T1D need to work with their healthcare team to determine an appropriate A1C level for their individual situation.
The Diabetes Research Connection (DRC) continues to follow updated guidelines and recommendations for managing type 1 diabetes. The organization plays an active role in contributing to the growing body of knowledge around the disease by providing critical funding to early-career scientists pursuing research projects focused on improving diagnosis, prevention, treatment, and management of T1D. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.