Hypoglycaemic episodes in children with insulin dependent diabetes mellitus--can the frequency or severity be reduced?

To ascertain if significant hypoglycaemic episodes can be avoided or managed more appropriately in children with insulin dependent diabetes mellitus (IDDM). A retrospective chart audit was performed on all children with IDDM admitted with hypoglycaemia between 1.1.90 and 31.8.97. Of the 21 children studied, 9 presented with seizures and 1 with coma. In 9 the hypoglycaemia was unexplained. Only 6 parents used glucagon. Five children were readmitted during the review with a further hypoglycaemic episode. Four of these had their first admission significantly sooner after diagnosis than those without recurrent episodes. Hypoglycaemic episodes are often unexplained and are unlikely to be completely avoidable. Improved support services during intercurrent illness may reduce the frequency of some hypoglycaemic episodes and increased use of glucagon at home may reduce the severity of some. Children who have their first hypoglycaemic episode within one year of diagnosis are at risk of having recurrent episodes.