Skip to main content
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Diabetes Care

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • My Cart

Search

  • Advanced search
Diabetes Care
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
Original Articles

Severe Hypoglycemia in Children With IDDM: A prospective population study, 1992–1994

  1. Sam Nordfeldt, MD and
  2. Johnny Ludvigsson, MD, PHD
  1. Department of Pediatrics, Faculty of Health Sciences Linkoping, Sweden
  1. Address correspondence and reprint requests to Johnny Ludvigsson, Department of Pediatrics, Faculty of Health Sciences, S-581 85 Linkoping, Sweden.
Diabetes Care 1997 Apr; 20(4): 497-503. https://doi.org/10.2337/diacare.20.4.497
PreviousNext
  • Article
  • Info & Metrics
  • PDF
Loading

Abstract

OBJECTIVE Is an increased incidence of severe hypoglycemia an unavoidable effect of improved metabolic control? And, if so, to what extent?

RESEARCH DESIGN AND METHODS In 1992–1994, severe hypoglycemia was prospectively registered in our intensively treated IDDM population, 146 children 1–18 years of age with > 90% of the patients on ≥ 4 insulin injections per day. The two categories, “severe hypoglycemia with unconsciousness” (U hypoglycemia) and “severe hypoglycemia without unconsciousness but needing the assistance of another person” (NU hypoglycemia), were analyzed in relation to yearly mean HbA1c levels, insulin doses and proportion of short-acting insulin, age at onset, duration of diabetes, age, sex, and weight-to-height ratio.

RESULTS Yearly mean HbA1c levels improved from 8.1 ± 1.6% in 1992 to 6.9 ± 1.3% in 1994. The yearly incidence of U hypoglycemia was 0.15–0.19 events per patient-year, seen in 10–16% of patients, showing no significant increase from 1992–1994. For NU hypoglycemia, slightly increasing figures from 1.01 to 1.26 events per patient-year, seen in 27–38% of patients yearly, were reported. There was no significant correlation between severe (U or NU) hypoglycemia and HbA1c, but still an association was seen in certain calculations. In multiple regression analysis, U hypoglycemia was not related to any factor, but the square root of the rate of NU hypoglycemia was related to lower HbA1c levels (P = 0.0003), higher insulin doses (IU · kg−1 · 24 h−1) (P = 0.0024), and a lower proportion of short-acting insulin out of the total daily insulin dose (P = 0.031).

CONCLUSIONS Multiple-dose insulin therapy with rather low yearly mean HbA1c values causes a slight increase of NU hypoglycemia but no increase of U hypoglycemia in our population of children with IDDM. Near physiological HbA1c levels may be achieved without any pronounced risk of increasing the incidence of severe hypoglycemia when multiple-injection insulin therapy is combined with adequate self-control based on psychosocial support and active education.

  • Received December 28, 1995.
  • Accepted November 12, 1996.
  • Copyright © 1997 by the American Diabetes Association

Log in using your username and password

Forgot your user name or password?

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.
PreviousNext
Back to top

In this Issue

April 1997, 20(4)
  • Table of Contents
  • Index by Author
Sign up to receive current issue alerts
View Selected Citations (0)
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Diabetes Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Severe Hypoglycemia in Children With IDDM: A prospective population study, 1992–1994
(Your Name) has forwarded a page to you from Diabetes Care
(Your Name) thought you would like to see this page from the Diabetes Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Severe Hypoglycemia in Children With IDDM: A prospective population study, 1992–1994
Sam Nordfeldt, Johnny Ludvigsson
Diabetes Care Apr 1997, 20 (4) 497-503; DOI: 10.2337/diacare.20.4.497

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Add to Selected Citations
Share

Severe Hypoglycemia in Children With IDDM: A prospective population study, 1992–1994
Sam Nordfeldt, Johnny Ludvigsson
Diabetes Care Apr 1997, 20 (4) 497-503; DOI: 10.2337/diacare.20.4.497
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

Original Articles

  • Obstetric Management in Gestational Diabetes
  • Prevention of Type 2 Diabetes in Women With Previous Gestational Diabetes
  • Cellular Mechanisms for Insulin Resistance in Normal Pregnancy and Gestational Diabetes
Show more Original Articles

Clinical Care/Education/Nutrition

  • Increased Second Trimester Maternal Glucose Levels Are Related to Extremely Large-for-Gestational-Age Infants in Women With Type 1 Diabetes
  • Effect of Renal Insufficiency on the Pharmacokinetics of Sitagliptin, a Dipeptidyl Peptidase-4 Inhibitor
  • A1C in Gestational Diabetes Mellitus in Asian Indian Women
Show more Clinical Care/Education/Nutrition

Similar Articles

Navigate

  • Current Issue
  • Standards of Care Guidelines
  • Online Ahead of Print
  • Archives
  • Submit
  • Subscribe
  • Email Alerts
  • RSS Feeds

More Information

  • About the Journal
  • Instructions for Authors
  • Journal Policies
  • Reprints and Permissions
  • Advertising
  • Privacy Policy: ADA Journals
  • Copyright Notice/Public Access Policy
  • Contact Us

Other ADA Resources

  • Diabetes
  • Clinical Diabetes
  • Diabetes Spectrum
  • Scientific Sessions Abstracts
  • Standards of Medical Care in Diabetes
  • BMJ Open - Diabetes Research & Care
  • Professional Books
  • Diabetes Forecast

 

  • DiabetesJournals.org
  • Diabetes Core Update
  • ADA's DiabetesPro
  • ADA Member Directory
  • Diabetes.org

© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.