Detection and treatment efficacy of hypoglycemic events in the everyday life of children younger than 7 yr. Issue 1 (27th June 2013)

• Record Type: Journal Article
• Authors: Sundberg, Frida; Forsander, Gun
• Is Part Of: Pediatric diabetes. Volume 15:Issue 1(2014:Feb.)
• Page Start: 34
• Page End: 40
• Publication Date: 2013-06-27
• Subjects: Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12057
• Languages: English
• ISSNs: 1399-543X

Abstract

<abstract abstract-type="main" id="pedi12057-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="pedi12057-sec-0001" sec-type="section"> <title>Background</title> <p id="pedi12057-para-0001">Mild hypoglycemia is commonly observed in children treated for type 1 diabetes mellitus (T1DM). Hypoglycemia disturbs cognition and learning.</p> </sec> <sec id="pedi12057-sec-0002" sec-type="section"> <title>Objective</title> <p id="pedi12057-para-0002">To describe how and to what extent hypoglycemia in young children with T1DM is detected in everyday life. To learn how parents and caregivers treat hypoglycemia and to evaluate how efficient this treatment is.</p> </sec> <sec id="pedi12057-sec-0003" sec-type="section"> <title>Methods</title> <p id="pedi12057-para-0003">Twenty‐three children [12 girls, mean age: 4.5 yr, mean HbA1c: 59 mmol/mol (7.5%)], 17 of whom were treated with an insulin pump, underwent blinded continuous glucose monitoring (CGM). Data on symptoms and treatment of hypoglycemia were collected in a logbook. Plasma glucose values were collected through self‐monitoring of blood glucose and entered in the logbook, and glucometer memories were uploaded. Data were collected during 1 wk in autumn and 1 wk in spring.</p> </sec> <sec id="pedi12057-sec-0004" sec-type="section"> <title>Results</title> <p id="pedi12057-para-0004">Only 32% of all hypoglycemic events were detected despite plasma glucose being checked 10 times per day. Most hypoglycemic events were asymptomatic (90% overall and 98% of those occurring at night). Untreated hypoglycemic events were associated with a relapse into hypoglycemia within 3 h in the majority of events. Compared to treatment of hypoglycemia events with a defined dose of simple carbohydrates, treatment with a mixed meal resulted in a significantly higher glucose value 1 and 2 h after the hypoglycemia.</p> </sec> <sec id="pedi12057-sec-0005" sec-type="section"> <title>Conclusion</title> <p id="pedi12057-para-0005">For optimum treatment, children younger than 7 yr with T1DM need better strategies and support for detecting hypoglycemia with real‐time CGM. Hypoglycemia should be treated with a defined dose of carbohydrates rather than a mixed meal.</p> </sec> </abstract>