Ross L A, McCrimmon R J, Frier B M, Kelnar C J, Deary I J
Department of Child Life and Health, University of Edinburgh, UK.
Diabet Med. 1998 Oct;15(10):836-43. doi: 10.1002/(SICI)1096-9136(199810)15:10<836::AID-DIA681>3.0.CO;2-S.
To compare the hypoglycaemic symptoms reported by children with Type 1 diabetes and signs observed by and symptoms reported to their parents, 101 pairs, consisting of a child with diabetes and one of their parents, were asked to report the frequency with which they experienced, or witnessed, each of 31 symptoms during hypoglycaemia. The hypoglycaemic symptoms reported by the children and the reported symptoms and signs observed by their parents were classified, using multivariate statistical analyses, and compared. Close agreement was observed between the children and their respective parents' scores for frequencies of most symptoms/signs, as demonstrated by Spearman's rank correlations (median tau s = 0.25, p < 0.02). Principal Components Analysis of the symptoms/signs observed by the parents showed three factors: autonomic, neuroglycopenic, and behavioural disturbance. Analysis of the symptoms experienced by the children also identified three factors: behavioural disturbance, malaise and a third factor consisting of a combination of autonomic and neuroglycopenic symptoms. The parents could differentiate three separate groups of reported hypoglycaemic symptoms and signs (autonomic, neuroglycopenic, and behavioural disturbance) in their children. The children reported a similar group of behavioural symptoms but did not discriminate between autonomic and neuroglycopenic symptoms. These findings have important implications for the education of parents and children with Type 1 diabetes regarding the symptoms and signs of hypoglycaemia.
为比较1型糖尿病患儿报告的低血糖症状以及父母观察到的体征和报告的症状,研究人员邀请了101对由糖尿病患儿及其一位父母组成的组合,让他们报告在低血糖期间经历或目睹31种症状中每种症状的频率。使用多变量统计分析对患儿报告的低血糖症状以及父母报告的症状和观察到的体征进行分类并比较。如Spearman等级相关性所示(中位数tau s = 0.25,p < 0.02),在大多数症状/体征的频率方面,患儿与其各自父母的得分之间观察到密切一致性。对父母观察到的症状/体征进行主成分分析显示出三个因素:自主神经症状、神经低血糖症状和行为障碍。对患儿经历的症状进行分析也确定了三个因素:行为障碍、不适以及由自主神经和神经低血糖症状组合而成的第三个因素。父母能够区分出孩子报告的低血糖症状和体征的三个不同组(自主神经症状、神经低血糖症状和行为障碍)。患儿报告了类似的一组行为症状,但未区分自主神经症状和神经低血糖症状。这些发现对于对1型糖尿病患儿及其父母进行低血糖症状和体征方面的教育具有重要意义。