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Hypoglycaemic symptoms reported by children with type 1 diabetes mellitus and by their parents
L A Ross1, R J McCrimmon, B M Frier
1Department of Child Life and Health, University of Edinburgh, UK. lar@srv2.med.ed.ac.uk
Insights
Children with Type 1 diabetes and their parents largely agree on hypoglycaemia symptoms. Parents distinguish autonomic, neuroglycopenic, and behavioral signs, while children group them differently, impacting diabetes education.
Area of Science:
- Pediatrics
- Endocrinology
- Psychology
Background:
- Type 1 diabetes management requires accurate recognition of hypoglycaemia.
- Discrepancies in symptom perception between children and parents can affect timely intervention.
Purpose of the Study:
- To compare hypoglycaemic symptom reporting by children with Type 1 diabetes versus parental observations.
- To analyze the classification of symptoms from both perspectives.
Main Methods:
- 101 child-parent pairs with Type 1 diabetes reported frequencies of 31 hypoglycaemic symptoms.
- Multivariate statistical analyses, including Spearman's rank correlations and Principal Components Analysis, were employed.
Main Results:
- Close agreement was found between children's and parents' symptom frequency scores (median tau s = 0.25, p < 0.02).
- Parents identified three symptom factors: autonomic, neuroglycopenic, and behavioral disturbance.
- Children reported behavioral symptoms but combined autonomic and neuroglycopenic symptoms.
Conclusions:
- Parents can differentiate distinct categories of hypoglycaemia symptoms in children.
- Children's symptom classification differs from parental observation, highlighting educational needs.
- Improved education for families managing Type 1 diabetes is crucial for recognizing and responding to hypoglycaemia.
Abstract:
To compare the hypoglycaemic symptoms reported by children with Type 1 diabetes and signs observed by and symptoms reported to their parents, 101 pairs, consisting of a child with diabetes and one of their parents, were asked to report the frequency with which they experienced, or witnessed, each of 31 symptoms during hypoglycaemia. The hypoglycaemic symptoms reported by the children and the reported symptoms and signs observed by their parents were classified, using multivariate statistical analyses, and compared. Close agreement was observed between the children and their respective parents' scores for frequencies of most symptoms/signs, as demonstrated by Spearman's rank correlations (median tau s = 0.25, p < 0.02). Principal Components Analysis of the symptoms/signs observed by the parents showed three factors: autonomic, neuroglycopenic, and behavioural disturbance. Analysis of the symptoms experienced by the children also identified three factors: behavioural disturbance, malaise and a third factor consisting of a combination of autonomic and neuroglycopenic symptoms. The parents could differentiate three separate groups of reported hypoglycaemic symptoms and signs (autonomic, neuroglycopenic, and behavioural disturbance) in their children. The children reported a similar group of behavioural symptoms but did not discriminate between autonomic and neuroglycopenic symptoms. These findings have important implications for the education of parents and children with Type 1 diabetes regarding the symptoms and signs of hypoglycaemia.