Hello everyone, I have multiple emails and forums posts about this topic, more than I can keep track of so this post supersedes all previous conversations. Since the chapter 12 update did not explicitly mention a fasting target of 4-7 mmol/L I kept the 2018 target of 4-8 mmol/L. However a student recently pointed out that Recommendation 1 (b) on pg 14 of the chapter 12 update states:

For children, recommended targets are the same for CBG, A1C, and sensor glucose as for adults, and in alignment with the International Society for Pediatric and Adolescent Diabetes Consensus Guidelines

So I feel its reasonable to assume that the fasting target has changed from 4-8 mmol/L to 4-7 mmol/L even though it is not explicitly stated. I will update the quizzes, tests and cheat sheets but this will take some time. If I have missed a question please email me at cdestudycourse@gmail.com. This also means that the Time in Range (TIR) are also the same as adults.

However this makes the new children A1c target of <7% instead of ≤7% even more confusing. Before the update the target A1c for children was less strict at ≤7.5% because children need a consistent level of glucose to myelinate their brain cells for proper development. Frequent hypoglycemia was thought to impair cognitive performance. So it doesn't make sense that the chapter 12 update now recommends a stricter than adult target of <7%. Another student who has connections to the chapter 12 update authors has verbally confirmed that the <7% A1c target is a mistake and they meant ≤7% which is in alignment for adults. We are waiting for email confirmation or an errata from the guideline authors. So this means in real life use the target of ≤7% for children but for the exam which is based on the guidelines I would use the as written target of <7%. Thanks Esmond