title: The impact of blood glucose and HbA(1c)  goals on glycaemic control in children and adolescents with Type 1 diabetes.
abstract: OBJECTIVE
  To evaluate parents' goals and parents' perceptions of physicians' goals for blood glucose and HbA(1c)  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 ± 2.3 years (range 8-16 years) with Type 1 diabetes for 6.3 ± 3.5 years, completed surveys regarding their goals and their perceptions of physicians' goals for their child's blood glucose and HbA(1c)  levels.
  
  
  RESULTS
  Children/adolescents had a mean HbA(1c)  of 69 ± 16 mmol/mol (8.4 ± 1.4%) and checked blood glucose levels 3.8 ± 1.2 times/day; 23% received pump therapy. Almost half of parents reported a blood glucose goal of 130 (80-180) mg/dl [7.2 (4.4-10) mmol/l]; 75% of parents reported a HbA(1c)  goal of 42-64 mmol/mol (6-8%). HbA(1c)  was significantly lower when parents reported HbA(1c)  goals ≤ 64 mmol/mol (≤ 8%) vs. > 64 mmol/mol (> 8%) [67 ± 14 mmol/mol (8.3 ± 1.2%) vs. 76 ± 20 mmol/mol (9.1 ± 1.8%), respectively, P = 0.02]. Parents' blood glucose and HbA(1c)  goals were tightly linked with parents' perceptions of physicians' blood glucose and HbA(1c)  goals (69% concordant, P < 0.0001; 88% concordant, P < 0.0001, respectively).
  
  
  CONCLUSIONS
  There was a significant association between lower parent HbA(1c)  goals and lower child/adolescent HbA(1c) . 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.
authors.affiliation: Pediatric, Adolescent and Young Adult Section, Genetics & Epidemiology Section, Joslin Diabetes Center, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Boot
authors.forename: L K
authors.initials: LK
authors.lastname: Volkening
authors.forename: D A
authors.initials: DA
authors.lastname: Butler
authors.forename: L M B
authors.initials: LM
authors.lastname: Laffel
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006040:Goals; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D010465:Perception
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin