Aman J, Karlsson I, Wranne L
Department of Paediatrics, Orebro Medical Centre Hospital, Sweden.
Diabet Med. 1989 Apr;6(3):257-61. doi: 10.1111/j.1464-5491.1989.tb01157.x.
The occurrence of severe and mild hypoglycaemic attacks and their symptoms and signs were studied in 92 insulin-dependent diabetic children, 7-18 years old. A questionnaire was distributed to all families and they were interviewed by an experienced nurse. Severe attacks, for which the help of an adult was needed, were reported by 44% of the children during a 12-month period. Thirty-seven per cent of the attacks occurred in the mornings, most often attributed to extra physical exercise, but equally often without any obvious cause. They were more common in children with strict blood glucose control measured as HbA1c. Fast-acting carbohydrates, given by parents, relieved the attack in most children, but 15% needed a glucagon injection and 12% intravenous glucose. In all, 16% were admitted to hospital. Mild events occurred in 97% of the children, at least once per week in 53% of the children, and were not related to blood glucose control. They were often attributed to extra physical exercise and occurred mainly between breakfast and lunch. Initial symptoms were tremor and hunger; during the whole event tremor and sweating were most common. Parents noted pallor as the most common sign. The frequency of severe or mild attacks could not be correlated to the age of the child, duration of diabetes, daily dose or number of insulin injections.
对92名7至18岁的胰岛素依赖型糖尿病儿童的严重和轻度低血糖发作及其症状和体征进行了研究。向所有家庭发放了问卷，并由一名经验丰富的护士进行访谈。在12个月的时间里，44%的儿童报告发生了需要成人帮助的严重发作。37%的发作发生在早晨，最常见的原因是额外的体育锻炼，但同样常见的是没有任何明显原因。在以糖化血红蛋白（HbA1c）衡量血糖控制严格的儿童中，发作更为常见。父母给予的速效碳水化合物能缓解大多数儿童的发作，但15%的儿童需要注射胰高血糖素，12%的儿童需要静脉注射葡萄糖。总共有16%的儿童住院治疗。97%的儿童发生过轻度低血糖事件，53%的儿童每周至少发生一次，且与血糖控制无关。这些事件通常归因于额外的体育锻炼，主要发生在早餐和午餐之间。最初的症状是震颤和饥饿；在整个事件中，震颤和出汗最为常见。父母指出面色苍白是最常见的体征。严重或轻度发作的频率与儿童年龄、糖尿病病程、每日胰岛素剂量或注射次数无关。
