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Severe hypoglycemia in children with insulin-dependent diabetes mellitus: frequency and predisposing factors

D Daneman1, M Frank, K Perlman

  • 1Department of Pediatrics, University of Toronto, Ontario, Canada.

The Journal of Pediatrics
|November 1, 1989
PubMed

Insights

Severe hypoglycemia is common in children with insulin-dependent diabetes mellitus, affecting 31% of those surveyed. This highlights a need for increased vigilance and education for prevention and treatment in pediatric diabetes management.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Diabetes Mellitus Research

Background:

  • Insulin-dependent diabetes mellitus (IDDM) requires careful management to prevent complications.
  • Hypoglycemia, particularly severe episodes, poses a significant risk in pediatric diabetes care.

Purpose of the Study:

  • To determine the frequency and characteristics of severe hypoglycemia in children with IDDM.
  • To assess current management and preparedness for severe hypoglycemic events in this population.

Main Methods:

  • Survey of 311 children with IDDM and their parents.
  • Review of hospital records to confirm reported severe hypoglycemic episodes.
  • Analysis of episode frequency, timing (sleep/awake), and patient demographics.

Main Results:

  • 31% of children reported severe hypoglycemia (coma/convulsion); 16% reported moderate hypoglycemia.
  • 53% had no history of moderate or severe hypoglycemia.
  • Severe episodes occurred more frequently in children with longer diabetes duration and younger age at onset; lower HbA1c levels were associated with severe hypoglycemia.

Conclusions:

  • Severe hypoglycemia is a common occurrence in children with IDDM under conventional treatment.
  • There is a need for enhanced vigilance and education regarding the prevention and management of severe hypoglycemia in pediatric diabetes.
  • Glucagon availability and utilization for home treatment of severe hypoglycemia were suboptimal.

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