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Pediatr Diabetes. 2015 Aug;16(5):354-60. doi: 10.1111/pedi.12171. Epub 2014 Jul 12.

Prevalence and predictors of severe hypoglycemia in Danish children and adolescents with diabetes.

Author information

1
Department of Pediatrics, Herlev University Hospital, Herlev, Denmark.
2
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
3
Department of Pediatrics, Viborg Regional Hospital, Viborg, Denmark.

Abstract

OBJECTIVE:

To investigate the prevalence of severe hypoglycemia in Danish children and adolescents with type 1 diabetes and to pinpoint predictors of this acute complication in children on modern treatment modalities.

RESEARCH DESIGN AND METHODS:

The study is based on data from DanDiabKids, a national diabetes register for children and adolescents. The register contains data on patients with type 1 diabetes with an ascertainment rate of 99%. Data from 3320 patients aged 0-18 yr was included in the study period from 1998 to 2009 and analyzed using a negative binomial model.

RESULTS:

One thousand nine hundred and ninety-nine episodes of severe hypoglycemia in 867 patients were registered conferring an overall incidence of severe hypoglycemia of 15.1 [95% confident interval (CI): 13.8; 16.4] per 100 patient years. This remained unchanged during the study period. Duration of diabetes, age and treatment in centers managing less than 100 patients significantly increased the risk of severe hypoglycemia (p < 0.001). Patients on insulin pump therapy had a 42% reduced risk of severe hypoglycemia compared with pen treated patients (p = 0.01). Patients treated with five or more daily insulin injections had a 31% (95% CI: 17; 49) reduced risk of severe hypoglycemia compared to patients on fewer daily injections (p = 0.015).

CONCLUSIONS:

Despite improvements in metabolic control over a decade the prevalence of severe hypoglycemic events remained unchanged. More intensive treatments such as insulin pump therapy and multiple daily injections on a national level seems to be a protective factor for developing severe hypoglycemia up to 2009.

KEYWORDS:

BMI; DCCT; HbA1c; HbA1c IDAA1c; IFCC; SDS; SMBG; glycemic control; pediatric; severe hypoglycemia; type 1 diabetes

PMID:
25039921
DOI:
10.1111/pedi.12171
[Indexed for MEDLINE]

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