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Symptomatic hypoglycaemia in 411 type 1 diabetic patients
S Pramming1, B Thorsteinsson, I Bendtson
1Steno Memorial Hospital, Gentofte, Denmark.
Summary
Symptomatic hypoglycemia, a common concern for Type 1 diabetes patients, occurred more frequently on weekdays and in the morning. Symptoms varied and lessened with longer diabetes duration.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Diabetes Management
Background:
- Symptomatic hypoglycemia is a significant complication in Type 1 diabetes management.
- Understanding the frequency and patterns of hypoglycemia is crucial for patient care and treatment optimization.
Purpose of the Study:
- To prospectively assess the frequency of symptomatic hypoglycemic episodes in conventionally treated Type 1 diabetic outpatients.
- To investigate factors influencing hypoglycemia frequency, including time of day, day of week, and patient characteristics.
Main Methods:
- A prospective study involving 411 Type 1 diabetic outpatients.
- Data collection included home questionnaires and a 1-week prospective diary recording of hypoglycemic episodes.
- Analysis correlated hypoglycemia frequency with insulin dosage, injection frequency, insulin type, HbA1c, age, and diabetes duration.
Main Results:
- Prospective frequencies were 1.8 mild and 0.027 severe episodes per patient-week.
- Hypoglycemia was more common on working days (1.8:1) and in the morning (4.5:2.2:1.4:1 ratio for morning:afternoon:evening:night).
- Symptoms were non-specific and diminished with longer diabetes duration; 36% experienced hypoglycemic coma. Weak correlations found with insulin dose, injections, unmodified insulin percentage, and HbA1c.
Conclusions:
- Symptomatic hypoglycemia is a frequent occurrence in Type 1 diabetes, with distinct temporal patterns.
- Hypoglycemia management requires attention to daily routines and time of day.
- While weakly correlated with certain treatment parameters, further research may be needed to fully elucidate contributing factors.