UNLABELLED: Daily insulin doses and HbA1c were studied 0-3 months before and 2-6, 7-11, and 12-16 months after 48 consecutive episodes of severe hypoglycaemia (coma and/or convulsion) in children and adolescents with insulin-dependent diabetes mellitus. After 69% of the attacks, either physicians or patients or both decreased daily insulin doses (for the whole group, mean SD: 0-3 months before the episode 0.93 0.20 U/kg vs 2-6 months after 0.84 0.20 U/kg, P < 0.001), which may have worsened the subsequent glycaemic control as evidenced by a significant increase in HbA1c (8.3+/-1.5% vs 9.1+/-1.8%, P< 0.001, respectively). Physicians decreased the insulin dose even in 14 of the 33 patients with a preventable cause for their hypoglycaemia other than erroneous excess of insulin. CONCLUSION: Experience of severe hypoglycaemia may worsen the subsequent glycaemic control. This might in part be due to an excessive lowering of daily insulin doses by both physicians as well as patients and their families. Hypoglycaemia management must include intensive education about prevention without compromising diabetes control.
UNLABELLED: Daily insulin doses and HbA1c were studied 0-3 months before and 2-6, 7-11, and 12-16 months after 48 consecutive episodes of severe hypoglycaemia (coma and/or convulsion) in children and adolescents with insulin-dependent diabetes mellitus. After 69% of the attacks, either physicians or patients or both decreased daily insulin doses (for the whole group, mean SD: 0-3 months before the episode 0.93 0.20 U/kg vs 2-6 months after 0.84 0.20 U/kg, P < 0.001), which may have worsened the subsequent glycaemic control as evidenced by a significant increase in HbA1c (8.3+/-1.5% vs 9.1+/-1.8%, P< 0.001, respectively). Physicians decreased the insulin dose even in 14 of the 33 patients with a preventable cause for their hypoglycaemia other than erroneous excess of insulin. CONCLUSION: Experience of severe hypoglycaemia may worsen the subsequent glycaemic control. This might in part be due to an excessive lowering of daily insulin doses by both physicians as well as patients and their families. Hypoglycaemia management must include intensive education about prevention without compromising diabetes control.
Authors: Daniela Elleri; Janet M Allen; Martin Tauschmann; Ranna El-Khairi; Paul Benitez-Aguirre; Carlo L Acerini; David B Dunger; Roman Hovorka Journal: BMJ Open Diabetes Res Care Date: 2014-12-11
Authors: Gianluca Musolino; Klemen Dovc; Charlotte K Boughton; Martin Tauschmann; Janet M Allen; Katrin Nagl; Maria Fritsch; James Yong; Emily Metcalfe; Dominique Schaeffer; Muriel Fichelle; Ulrike Schierloh; Alena G Thiele; Daniela Abt; Harald Kojzar; Julia K Mader; Sonja Slegtenhorst; Nicole Ashcroft; Malgorzata E Wilinska; Judy Sibayan; Nathan Cohen; Craig Kollman; Sabine E Hofer; Elke Fröhlich-Reiterer; Thomas M Kapellen; Carlo L Acerini; Carine de Beaufort; Fiona Campbell; Birgit Rami-Merhar; Roman Hovorka Journal: Pediatr Diabetes Date: 2019-06-13 Impact factor: 4.866
Authors: J R Law; G Yeşiltepe-Mutlu; S Helms; E Meyer; E Özsu; F Çizmecioğlu; F C Lin; Ş Hatun; A S Calikoglu Journal: Diabet Med Date: 2014-07-15 Impact factor: 4.359