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Many Children Cannot Detect Hypoglycemia
What is the problem and what is known about it so far?
Controlling blood glucose levels can help prevent complications from diabetes such as eye, kidney, and nerve problems. However, insulin, often needed to control blood glucose, can cause hypoglycemia (low blood glucose levels), which can become a medical emergency if not treated quickly. Most patients notice symptoms of hypoglycemia and can check their glucose levels and treat low levels quickly. But some patients have “hypoglycemia unawareness,” which means they do not notice symptoms until their blood glucose level becomes dangerously low. Hypoglycemia is a particularly difficult problem for diabetic children and adolescents who take insulin and for their adult caregivers. Children’s and parents’ fears of hypoglycemia can keep them from successfully controlling diabetes. Repeated episodes of serious hypoglycemia can have lasting effects on children’s brains and can worsen hypoglycemia unawareness.
Why did the researchers do this particular study?
The researchers wanted to learn more about hypoglycemia unawareness in children and adolescents with diabetes.
Who was studied?
The study included 656 children and adolescents with type 1 diabetes who got their diabetes care at a clinic in Western Australia.
How was the study done?
Participants (or, in the case of very young children, their caregivers) completed questionnaires about how well they noticed hypoglycemia symptoms. Researchers also looked at participant’s medical records to see how often they had had severe hypoglycemia.
What did the researchers find?
Nearly 30% of the participants had problems recognizing hypoglycemia. Those with hypoglycemia unawareness had had diabetes longer, were younger, and had worse overall diabetes control than those who could better recognize hypoglycemia. Participants with hypoglycemia unawareness were about twice as likely to have serious hypoglycemia episodes. This problem was even worse in children under the age of 6 who had hypoglycemia unawareness. These children were six times as likely to have severe hypoglycemia episodes. Children who had serious hypoglycemia numerous times were more likely to have problems detecting signs of hypoglycemia.
What are the implications of the study
Many diabetic children and adolescents have hypoglycemia unawareness. It is important to screen for this problem to find out which young people are at risk for serious hypoglycemia episodes. Preventing hypoglycemia in adults can restore their ability to detect low blood glucose levels. It is likely that this is also true for children.
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