STOCKHOLM – Hypoglycemia occurred an average of nearly five times a week among 14 children with type 1 diabetes aged younger than 7 years who were evaluated in a prospective study.
“We need to identify age-specific strategies to improve insulin treatment for preschool children,” said Dr. Frida Sundberg of Queen Silvia Children’s Hospital, Gothenburg, Sweden.
The study included 14 children seen at the hospital who met the inclusion criteria of less than 7 years of age, a type 1 diabetes duration of more than 3 months, and the ability of the parents to upload at least 300 days’ worth of glucose values from the child’s glucose meter. Data were collected prospectively from autumn 2008 until autumn 2009. The eight boys and six girls had a mean age of 4.8 years and diabetes duration of 2.4 years.
Eleven were on pump therapy and three were on multiple injections at the start of the study, and one shifted to a pump during the year. They had a mean hemoglobin A1c value of 7.8%, with seven of the children achieving the target of less than 7.5% recommended by the International Society for Pediatric and Adolescent Diabetes, Dr. Sundberg reported.
They averaged 7.8 self blood glucose measurements per day, including a mean of 1.2 readings during the night (10:00 p.m.-6:00 a.m.). Hypoglycemia, defined as a value less than 4 mmol/L (72 mg/dL), occurred an average of 0.66 times per day/4.6 times per week. The mean number of nights with detected hypoglycemia was 21 (4-42) per patient year, or 6% of all nights. Severe hypoglycemia, defined as seizures or unconsciousness, was reported twice by one child and once by another, for a rate of 21 events per 100 patient years.
“Further data on how to balance nutrition, insulin, and physical activity in order to achieve good glycemic control, and thereby preserve health and quality of life in the short and long perspective are needed,” she concluded.
This study was supported by Barndiabetesfonden. Dr. Sundberg stated that she had no further disclosures.