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).

新增与差异内容摘要
1. 本章为可获得持续葡萄糖监测（continuous glucose monitoring, CGM）与自动胰岛素输注（automated insulin delivery, AID）等先进糖尿病诊疗技术的人群，推荐糖化血红蛋白（HbA1c）控制目标为≤6.5%（48mmol/mol）；该目标应作为所有罹患糖尿病的儿童及青少年的推荐控制目标，在安全可实现的前提下予以推行。在其他临床场景下，糖化血红蛋白控制目标为≤7.0%（53mmol/mol）。设定更低的糖化血红蛋白控制目标是经过审慎考量的：现有日益增多的证据表明，将糖化血红蛋白控制在既往目标值以下可显著降低糖尿病并发症的发生风险；且在配备充足技术手段与医护专业支持的前提下，达成该更低血糖控制目标可安全实现，不会增加低血糖风险或加重照护负担。
2. 上述血糖控制目标可根据糖尿病患者及其照护者面临的潜在挑战进行个体化调整。
3. 本章还讨论了血糖控制目标与体质量超重发生率之间的关联。
4. 相较于既往版本，本章内容更为凝练。本章旨在为整体血糖管理提供更新后的核心指导意见，同时可结合其他国际儿童青少年糖尿病学会（International Society for Pediatric and Adolescent Diabetes, ISPAD）共识指南获取更详细的背景信息与细分内容——这些指南涵盖了特定人群（如学龄前儿童）、医疗资源受限的照护场景，或特定临床情况（如运动相关血糖管理）等场景。