Detection and treatment efficacy of hypoglycemic events in the everyday life of children younger than 7 yr
Article first published online: 27 JUN 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Volume 15, Issue 1, pages 34–40, February 2014
How to Cite
Detection and treatment efficacy of hypoglycemic events in the everyday life of children younger than 7 yr., .
- Issue published online: 28 JAN 2014
- Article first published online: 27 JUN 2013
- Manuscript Accepted: 14 MAY 2013
- Manuscript Revised: 24 MAR 2013
- Manuscript Received: 17 JAN 2013
- The Swedish childhood diabetes foundation
- Inger Hulthman med fleras fonder/Göteborgs Diabetesförening
- Svenska Diabetesstiftelsen
- DSBUS fonder
- The Samariten Foundation
- The Göteborg Medical Society
- pre-school children;
- self-monitored plasma glucose;
Mild hypoglycemia is commonly observed in children treated for type 1 diabetes mellitus (T1DM). Hypoglycemia disturbs cognition and learning.
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.
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.
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.
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.