CDA Clinical Practice Guidelines 2013

Yesterday the Canadian Diabetes Association released their new Clinical Practice Guidelines 2013.

I've quickly reviewed Chapter 34 on Type 1 Diabetes in Children and Adolescents.

The biggest change that I noticed was the change in glycemic targets for this populations in the <6 and 6-12 years old.

<6 years old: A1C < 8.0% and FPG of 6-10 mmol/L, down from < 8.5% and 6-12 mmol/L.

6-12 years old: A1C < 7.5% and FPG of 4-10 mmol/L, down from < 8.0% and still 4-10 mmol/L.

13-18 years old: A1C < 7.0% and FPG of 4-7 mmol/L, the same as before.

I'm happy to see these changes.  I know before Amy was 6, they were always at me that her readings were fine when she was around 12 mmol/L, but I hated her there.  Even know our CDE tells us that the range should be graduated to the child's age, which it does state in the guidelines, but I feel Amy behaves different the higher her sugar is.  She also feels different in the higher range.  She is at her best between 5.5-8 mmol/L.  I find above or below this, we start running into problems.

Last week we had our quarterly appointment in St. John's.  She was only on the pump for 4 weeks before having her A1C done.  Before this, she had a number of 2pm highs.....very high.....like in the 20s, almost every day.  I'm not expecting much of a reduction, but I'm hoping for some.

She is still having some highs, especially before recess, at 10am, but we're working on it.

What do you think of the new targets?