Glucose Parameters for Diabetic Children

Jilaweez, BSN, MSN, RN · Oct 30, 2008

I'm pretty sure if varies by age. For toddlers it is usually 110-180 before a meal and sometimes higher overnight because they worry about them dropping low during sleep. For school aged kids it's higher, and then it increases slightly again for adolescents.

My son is three, he's been diabetic since one, and his target range is 80-150.

I like this first link the best, it breaks it down by age and HbA1C levels:

http://ndep.nih.gov/diabetes/youth/youth_FS.htm#Goals

http://www.jdrf.org/index.cfm?page_id=103442#uno

http://www.jdrf.org/index.cfm?fuseaction=home.viewpage&page_id=9F75E4DA-1321-C834-036D59A180E1A0E2

pagandeva2000, LPN · Oct 30, 2008

I really, really appreciate this from the bottom of my heart! Thank you for sharing with me.

blondy2061h, MSN, RN · Oct 30, 2008

I'm pretty sure if varies by age. For toddlers it is usually 110-180 before a meal and sometimes higher overnight because they worry about them dropping low during sleep. For school aged kids it's higher, and then it increases slightly again for adolescents.
My son is three, he's been diabetic since one, and his target range is 80-150.
I like this first link the best, it breaks it down by age and HbA1C levels:
http://ndep.nih.gov/diabetes/youth/youth_FS.htm#Goals
http://www.jdrf.org/index.cfm?page_id=103442#uno
http://www.jdrf.org/index.cfm?fuseaction=home.viewpage&page_id=9F75E4DA-1321-C834-036D59A180E1A0E2

I'm not really sure what you mean by "higher." Higher, as in, aiming for higher glucoses at that age? When you get older, the target goes down, actually. I was diagnosed with type 1 as a teenager, and my targets were 80-120 usually, and

My understanding was that toddlers have higher targets mainly because inability to communicate hypoglycemia symptoms (and also for fears of lows sleeping, and variably eating and sleeping schedules, and all that).

pagandeva2000, LPN · Oct 30, 2008

I'm not really sure what you mean by "higher." Higher, as in, aiming for higher glucoses at that age? When you get older, the target goes down, actually. I was diagnosed with type 1 as a teenager, and my targets were 80-120 usually, and
My understanding was that toddlers have higher targets mainly because inability to communicate hypoglycemia symptoms (and also for fears of lows sleeping, and variably eating and sleeping schedules, and all that).

I think that I was looking for parameters for the toddlers and school age groups. Children have irregular eating habits and are also more energetic than adults. From what I see, the reason why the parameters should be a bit higher is to compensate for the irregular eating. I am not an endocrine expert, but to me, the teenager may be a bit more stabilized and better able to articulate and observe for hypo/hyperglycemia (as well as to hopefully have the comprehension to self treat).

blondy2061h, MSN, RN · Oct 30, 2008

Pagandeva- my response was mostly in reference to the OP saying that the two hour post meal target should be less than 180- for adults, it really should be lower, and the first response saying teenagers have higher targets than toddlers- they are usually lower.

With flexible insulin dosing, such as insulin pumps (which young children often use), the whole variable meal thing is way less of an issue than it was in the past. Obviously, however, it's still an issue to a degree. There's many reasons, though.

Another one I forgot in my first response was that kids are often very insulin sensitive, so it can be hard to find a dose that gets them normal blood sugars without a huge risk of hypoglycemia.

pagandeva2000, LPN · Oct 31, 2008

Pagandeva- my response was mostly in reference to the OP saying that the two hour post meal target should be less than 180- for adults, it really should be lower, and the first response saying teenagers have higher targets than toddlers- they are usually lower.
With flexible insulin dosing, such as insulin pumps (which young children often use), the whole variable meal thing is way less of an issue than it was in the past. Obviously, however, it's still an issue to a degree. There's many reasons, though.
Another one I forgot in my first response was that kids are often very insulin sensitive, so it can be hard to find a dose that gets them normal blood sugars without a huge risk of hypoglycemia.

Thanks for the clarity. We work in an adult clinic, but the case manager had a discussion with a diabetic that also has a diabetic child. It was then that we realized that we didn't have enough information and this was worth investigating.

Jilaweez, BSN, MSN, RN · Nov 2, 2008

I really, really appreciate this from the bottom of my heart! Thank you for sharing with me.

You are very welcome!

pagandeva2000, LPN · Nov 2, 2008

You are very welcome!

I passed the sites on to the case manager. She was beside herself with happiness.

Jilaweez, BSN, MSN, RN · Nov 2, 2008

I'm not really sure what you mean by "higher." Higher, as in, aiming for higher glucoses at that age? When you get older, the target goes down, actually. I was diagnosed with type 1 as a teenager, and my targets were 80-120 usually, and
My understanding was that toddlers have higher targets mainly because inability to communicate hypoglycemia symptoms (and also for fears of lows sleeping, and variably eating and sleeping schedules, and all that).

Oh my gosh, yes you are right, I meant to say the target gets lower as the children get older, but the targets might be higher for overnight. This is what I get for posting after a few night shifts! My brain doesn't function. Thanks for the correction.

I do know that a BG of 180 is not ideal for anyone,even diabetics, but that is a range that I have seen for children throughout most of my research. The range can be higher or lower depending on the child. For instance my son's target was lowered to 80-150 after he had a lot of high bg's. It has also been raised if he has frequent hypo's. It's not set in stone. It's not unreasonable for a small child to have such high targets as 180 if the risks of hypoglycemia outweigh the risks of hyperglycemia. My husband is also a diabetic and he has a much more narrow target than does my son.

Thanks again for correcting my mistake!

blondy2061h, MSN, RN · Nov 2, 2008

Yeah, I pretty much strive for normal blood sugars, but I'm an adult, on an insulin pump, etc. I do go for a higher bedtime (whenever that is ) target if I've had a lot of activity that day, and try to be 150-180 before any sort of high intensity work out.