Harvengt Antoine, Maure Anaïs, Beckers Maude, Boutsen Laure, Brunelle Chloé, Costenoble Elise, Lysy Philippe
Pôle EDIN, Institut de Recherche Expérimentale Et Clinique, UCLouvain, Brussels, Belgium.
Specialized Pediatrics Service, Institute/Universisty/Hospital, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium.
Eur J Pediatr. 2025 Jan 30;184(2):162. doi: 10.1007/s00431-025-05992-2.
To evaluate the management and costs of severe hypoglycemia (SH) in children and adolescents with type 1 diabetes (T1D) in our Belgian tertiary pediatric care center. In the EPI-GLUREDIA study, clinical parameters from children and adolescents with T1D were retrospectively analyzed from July 2017 to June 2024. The characteristics of SH and its treatment were collected during the medical consultation following the SH episode. Between July 2017 and June 2024, 208 cases of SH were recorded in 113 children and adolescents with T1D, with an average age of 13.6 years and T1D duration of 6.2 years. Oral glucose was the most common treatment (47.4%), while glucagon was used in only 25.4% of cases and more frequently in boys (30.8%) than in girls (18.7%). Notably, only 43% of SH episodes were treated according to international guidelines. A significant increase in glucagon use was observed after reimbursement of its intranasal form in Belgium in January 2022. After 2022, glucagon use significantly increased (28/81 vs. 25/129; p = 0.013), particularly among teachers and educators (18/49 vs. 10/78; p = 0.002). The average direct cost of treating SH was €187.9, with costs ranging from €0 to €1092.5 depending on the treatment method.Conculusion: Our study underscores the difficulty in managing SH in young people with T1D, with only 43% being treated as per guidelines. Since 2022, the increased use of the intranasal form of glucagon in Belgium led to reduced healthcare costs and improved care of patients experiencing SH.
评估我们比利时三级儿科护理中心1型糖尿病（T1D）儿童和青少年严重低血糖（SH）的管理情况及成本。在EPI - GLUREDIA研究中，对2017年7月至2024年6月期间T1D儿童和青少年的临床参数进行了回顾性分析。在SH发作后的医疗咨询过程中收集了SH的特征及其治疗情况。2017年7月至2024年6月期间，在113名T1D儿童和青少年中记录了208例SH病例，平均年龄为13.6岁，T1D病程为6.2年。口服葡萄糖是最常见的治疗方法（47.4%），而仅25.4%的病例使用了胰高血糖素，且在男孩中使用频率（30.8%）高于女孩（18.7%）。值得注意的是，只有43%的SH发作是按照国际指南进行治疗的。2022年1月比利时鼻内用胰高血糖素报销后，观察到其使用量显著增加。2022年后，胰高血糖素的使用显著增加（28/81 vs. 25/129；p = 0.013），尤其是在教师和教育工作者中（18/49 vs. 10/78；p = 0.002）。治疗SH的平均直接成本为187.9欧元，根据治疗方法不同，成本范围从0欧元到1092.5欧元不等。结论：我们的研究强调了T1D青少年管理SH的困难，只有43%的病例按指南治疗。自2022年以来，比利时鼻内用胰高血糖素使用量的增加降低了医疗成本，并改善了SH患者的护理。
