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Symptomatic hypoglycaemia in childhood diabetes: a population-based questionnaire study
1Department of Paediatrics, Orebro Medical Centre Hospital, Sweden.
Insights
Severe hypoglycemia attacks in insulin-dependent diabetic children require adult help and are linked to strict glucose control. Mild attacks are frequent and not related to blood glucose control.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Hypoglycemia is a common complication in children with insulin-dependent diabetes mellitus.
- Understanding the frequency, triggers, and management of hypoglycemic attacks is crucial for pediatric diabetes care.
Purpose of the Study:
- To investigate the occurrence, symptoms, and signs of severe and mild hypoglycemic attacks in insulin-dependent diabetic children.
- To identify factors associated with severe hypoglycemic attacks, including blood glucose control and timing.
Main Methods:
- A study involving 92 children (7-18 years old) with insulin-dependent diabetes.
- Data collected via questionnaires and interviews with families by an experienced nurse over a 12-month period.
Main Results:
- 44% of children experienced severe hypoglycemic attacks requiring adult assistance.
- Severe attacks were more frequent in children with stricter blood glucose control (HbA1c).
- 97% of children experienced mild hypoglycemic events, often weekly, not related to blood glucose control.
Conclusions:
- Severe hypoglycemic attacks in diabetic children are linked to stringent glycemic management and can necessitate medical intervention.
- Mild hypoglycemic events are common, often triggered by physical activity, and present with specific symptoms like tremor and sweating.
Abstract:
The occurrence of severe and mild hypoglycaemic attacks and their symptoms and signs were studied in 92 insulin-dependent diabetic children, 7-18 years old. A questionnaire was distributed to all families and they were interviewed by an experienced nurse. Severe attacks, for which the help of an adult was needed, were reported by 44% of the children during a 12-month period. Thirty-seven per cent of the attacks occurred in the mornings, most often attributed to extra physical exercise, but equally often without any obvious cause. They were more common in children with strict blood glucose control measured as HbA1c. Fast-acting carbohydrates, given by parents, relieved the attack in most children, but 15% needed a glucagon injection and 12% intravenous glucose. In all, 16% were admitted to hospital. Mild events occurred in 97% of the children, at least once per week in 53% of the children, and were not related to blood glucose control. They were often attributed to extra physical exercise and occurred mainly between breakfast and lunch. Initial symptoms were tremor and hunger; during the whole event tremor and sweating were most common. Parents noted pallor as the most common sign. The frequency of severe or mild attacks could not be correlated to the age of the child, duration of diabetes, daily dose or number of insulin injections.