Severe hypoglycaemia in children and adolescents during multiple-dose insulin therapy

Publisher Website
Google Scholar
Abstract
Episodes of severe hypoglycaemia, resulting in coma and/or convulsions, were documented in an unselected, population‐based group of 376 children and adolescents with Type 1 diabetes mellitus (Type 1 DM) treated at the Aurora Hospital, City of Helsinki. A prospective study in 1994–95 yielded 493 patient‐years and a retrospective study in 1990–93, 904 patient‐years of data. Of these patients, 77–85 % received insulin in three or more daily doses. During 1990–95, 43 patients had a total of 48 severe hypoglycaemic episodes. For each episode (n = 48), one control Type 1 DM patient who had never experienced any severe hypoglycaemia, matched by age, diabetes duration and puberty, was sought from the study population. Incidence of severe hypoglycaemia was 3.1/100 patient years prospectively and 3.6/100 retrospectively. At the time of the episode, median age was 13.3 (range 2.2–21) years, and median diabetes duration 6.1 (0.5–14.6) years. Rates were similar in different age groups (p = 0.04) and HbA1c lower (p = 0.005) in patients with severe hypoglycaemia than in controls. In conclusion, multiple‐dose insulin therapy in young patients with Type 1 DM can be associated with a low rate of severe hypoglycaemia. The majority of such episodes seem to be preventable. © 1998 John Wiley & Sons, Ltd.