Supplementary Material for: ISPAD Clinical Practice Consensus Guidelines 2024: Glycemic Targets

Summary of what is New or Different

1.This chapter recommends a target HbA1c of ≤6.5% (48mmol/mol) for those who have access to advanced diabetes technologies like continuous glucose monitoring (CGM) and automated insulin delivery (AID). This target should be encouraged for all children and adolescents living with diabetes when safely achievable. In other settings, the HbA1c target is ≤7.0% (53mmol/mol). The emphasis on the lower HbA1c target is deliberate, based on the growing evidence that achieving HbA1c levels below previous targets can significantly reduce the risk of developing diabetes complications and that when adequate technology and healthcare professional support are available, these lower glycemic targets can be safely achieved without increasing the risk of hypoglycemia or adding to the care burdens.
2.These glycemic goals may be individualized based on an assessment of the potential challenges for the person with diabetes and their caregivers.
3.The relationship between glycemic targets and rates of excess body weight are discussed.
4.The glycemic target chapter is also more succinct compared to previous iterations. This chapter is meant to provide updated guidance on overall glycaemic management alongside other ISPAD consensus guidelines that provide further context and information, including specific populations (e.g. pre-schooler children, limited care settings), or situations (e.g. exercise).