Diabetes Unit, Department of Pediatrics, Sahlgrenska Academy, The Queen Silvia Children's Hospital/Sahlgrenska University Hospital, SE 41685, Gothenburg, Sweden.
Pediatr Diabetes. 2014 Feb;15(1):34-40. doi: 10.1111/pedi.12057. Epub 2013 Jun 27.
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.
儿童 1 型糖尿病（T1DM）治疗中常出现轻度低血糖。低血糖会干扰认知和学习。
描述在日常生活中如何以及在何种程度上检测到 T1DM 幼儿的轻度低血糖。了解父母和照顾者如何治疗低血糖，并评估这种治疗的效果。
23 名儿童（12 名女孩，平均年龄 4.5 岁，平均 HbA1c：59mmol/mol（7.5%）），其中 17 名接受胰岛素泵治疗，进行了盲法连续血糖监测（CGM）。通过日志记录收集有关低血糖症状和治疗的数据。通过自我监测血糖收集血浆葡萄糖值并记录在日志中，并上传血糖仪记忆。数据在秋季和春季各收集了 1 周。
尽管每天检查 10 次血糖，但仍仅检测到所有低血糖事件的 32%。大多数低血糖事件是无症状的（总体 90%，夜间发生的 98%）。未经治疗的低血糖事件与大多数事件中在 3 小时内再次发生低血糖相关。与用固定剂量简单碳水化合物治疗低血糖事件相比，用混合餐治疗低血糖事件后 1 小时和 2 小时的血糖值显著更高。
为了进行最佳治疗，年龄小于 7 岁的 T1DM 儿童需要更好的策略和支持，以便使用实时 CGM 检测低血糖。低血糖应使用固定剂量的碳水化合物治疗，而不是混合餐。
