Debate: Which targets should we aim for-pro HbA < 7.5%

Abstract

The England & Wales NHS NICE 2015 guidance has set the team target for HbA as 48 mmol/mol (6.5%) or less for children and young adults with type 1 and type 2 diabetes. The evidence shows that this is associated with a reduction in morbidity and that, continuing below this value, there is a health advantage in even lower levels of glycosylation. There is much more to diabetes care than HbA1c and all individual targets must be set in conjunction with the young person and families taking into account their medical and social circumstances. But it is also important to inform the young people and families from the time of diagnosis of the team goals, to set their expectations. It is clear that having a goal for the team to try to achieve near normoglycaemia and a consistent message of how this may be achieved drives a steady improvement in standards. Proponents of setting a higher value have argued that this level of control is unachievable, or that it places too great a strain on individuals and families or that there will be increased hypoglycaemia. These arguments are unsustainable and the proposer in this debate will show evidence for this assertion.L6190425382017-11-07 <br />