Assessment and monitoring of metabolic control

Targets

  • For each individual the target should be the lowest achievable HbA1c without the occurrence of frequent or severe hypoglycemia (see Table 5 for specific target indicators of glycemic control)

  • A proportion of children should expect to achieve an HbA1c within the normal reference range at some time in the first year after diagnosis (during the partial remission phase)
  • The DCCT showed that as HbA1c rises above 7.5% (or more than approximately 120% above the upper level of the normal reference range), the risk of later microvascular complications increases steeply
    [In the DCCT intensive treatment group of adolescents, fewer than 50% achieved a mean HbA1c <8% (reference range <6.05%)]
 
Fructosamine and other glycated products

 
 
Consensus Guidelines 2000
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IDF Type 1 Guidelines
IDF Type 2 Guidelines