[Severe hypoglycemia in children and adolescents suffering from type 1 diabetes mellitus].

UNLABELLED

Hypoglycemia is the main fear of diabetic children and their parents. Severe hypoglycemia and diabetes ketoacidosis are medical emergencies that concern a patient's life prognosis.

AIM

To determine the rate of occurrence of severe hypoglycemia and identification of the latter's causes.

MATERIAL AND METHOD

The study was carried out on a group of 84 children and adolescents suffering from type 1 diabetes, whom were investigated to determine the rate of occurrence of severe hypoglycemia episodes in the last 12 months, to identify their risk factors and to try to establish a relation between the onset of hypoglycemia and certain parameters like age, duration of disease, insulin therapy, metabolic control.

RESULTS

23 of the 84 patients reported at least one severe hypoglycemia in the last 12 months. 47% of the cases of hypoglycemia were caused by the patient's failure to observe the meal timetable, which led to delays in the carbohydrates intake, 19% were due to a high physical effort and 14% by excessive insulin administration. Most of the patients with severe hypoglycemia, that is 20 if 23, were on a multiple insulin injection treatment. As concerns the blood sugar balance, the mean Hb A1c values were between 6.4% and 9.1%, the severe hypoglycemia episodes occurred both in patients with very good metabolic control and in those with poor blood sugar balance.

CONCLUSIONS

Severe hypoglycemia occurred in 27.3% of the children and adolescents suffering from type 1 diabetes, the most frequent cause revealed by this study being the delay in the carbohydrates intake. The prevention of this acute metabolic complication by a continuous medical education of diabetic patients is essential.