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The aim of diabetes care is to maximize quality and length of life by:

• Providing education and training to manage the disease and its treatment
• Developing an understanding to facilitate coping with new challenges
• Controlling the risk of damage to the eye, kidney, foot and arterial circulation
• Early detection and management of any complications of diabetes

Treatment for anyone with diabetes must include reducing the risk of cardiovascular disease, especially control of blood pressure, cessation of smoking, and correction of cholesterol and lipid abnormalities.

Persons with diabetes benefit from a comprehensive, multidiscipline approach to their care to optimize diabetic control as well as to prevent and monitor potential complications. Important members of the team may include:

• Primary care provider
• Endocrinologist - to optimize diabetic care
• Nurse
• Dietician
• Ophthalmologist (eye doctor) - should be seen yearly for evaluation
• Podiatrist (foot doctor)
• Vascular surgeon
• Nephrologist (kidney specialist)

The American Diabetes Association recommends the following goals for blood glucose controls:

• Preprandial glucose: 90 - 130 mg per dL
• Postprandial glucose: <180 mg per dL
• Hemoglobin A1c (HgbA1c): < 7 % in adults

In children with type 1 diabetes, glycemic goals have traditionally been based on the age of the child because of physiologic and developmental factors. The standard of care published by the American Diabetes Association recommends that children below the age of 6 years have a HgbA1c between 7.5% and 8.5%. The reason for this is the relationship between hypoglycemia and the potential for neuropsychological impairment. The recommended HgbA1c level for children in the 6-12 year range is < 8%; and a level <7.5% is recommended for children aged 13-19 years.

While there are benefits to maintaining tight control of blood sugar levels, there is also higher risk for episodes of hypoglycemia. The risks and benefits must, therefore, be weighed for each individual. It may be determined that the benefits of tight glycemic control are outweighed by the increased risk of serious complications from hypoglycemia in elderly persons, for example.