STOCKHOLM (EGMN) – 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.
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斯德哥尔摩(EGMN)——一项前瞻性研究对14例年龄＜7岁的1型糖尿病患儿进行的评估表明，患儿平均每周会出现近5次低血糖发作。
本研究共纳入14例(男性8例，女性6例)年龄＜7岁且病程＞3个月的1型糖尿病住院患儿，且患儿父母均提可供时间跨度＞300天的血糖仪血糖监测值。研究者在研究期间(2008年秋季~2009年秋季)对数据进行了前瞻性收集。患儿平均年龄4.8岁，糖尿病病程平均时长2.4年。在研究开始时，有11例患儿使用胰岛素泵治疗，余下3例患儿通过多次注射胰岛素进行治疗，其中1例在研究期间改用胰岛素泵治疗，糖化血红蛋白(Hb A1c)均值为7.8%，其中7例已达到国际儿童和青少年糖尿病协会推荐的7.5%的控制目标。
患儿每天平均自测血糖7.8次，夜晚(晚10点~早6点)平均测量1.2次。低血糖[血糖值＜4 mmol/L (72 mg/dl)]每天平均发作0.66次(折合4.6次/周)。平均每例患儿年低血糖出现天数为21天(4~42天，约占全年总天数的6%)。研究期间1例患儿曾出现2次严重低血糖(定义为低血糖伴癫痫发作或出现昏迷)，另有1例患儿出现1次，平均发作频率为21次/100(患者·年)。
作者表示，对儿童和青少年糖尿病患者进行评估，将有助于为学龄前儿童开发年龄特异性治疗方案。
本研究由Barndiabetesfonden公司赞助。研究者表示无进一步细节披露。
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