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Effective treatment of hypoglycemia in children with type 1 diabetes: a randomized controlled clinical trial
Author(s) -
McTavish Lindsay,
Wiltshire Esko
Publication year - 2011
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2010.00725.x
Subject(s) - medicine , hypoglycemia , interquartile range , randomized controlled trial , diabetes mellitus , type 2 diabetes , orange juice , type 1 diabetes , gastroenterology , endocrinology , food science , chemistry
McTavish L, Wiltshire E. Effective treatment of hypoglycemia in children with type 1 diabetes: a randomized controlled clinical trial. Objective: To determine the most effective of four oral treatments for hypoglycemia in children with type 1 diabetes using a weight‐based protocol during diabetes camp. Methods: During diabetes camp treatment of hypoglycemia was randomized to one of the four treatments, randomly assigned for each episode using a sealed envelope: glucose tablets, jellybeans, orange juice, and sugar mints (Mentos dragees®). An equivalent carbohydrate dose was calculated for each patient for each treatment (0.3 g carbohydrate/kg) and provided to camp leaders. Glucose was measured at 0, 2, 5, 10, and 15 min and symptoms recorded. Results: A total of 191 episodes of hypoglycemia were recorded in 39 children (1–12 episodes per child), with 2 episodes excluded because of protocol violations. Fifty‐two episodes were treated with glucose tablets, 45 with jellybeans, 44 with juice, and 48 with sugar mints. Change in glucose at 10 (p = 0.034) and 15 min (p = 0.005) and glucose at 15 min (p = 0.026) were significantly different between treatment groups – jellybeans produced the lowest and slowest response. Glucose tablets did not differ significantly from juice or Mentos dragees. There was a trend for repeat treatment to be required more often with a single treatment ‘dose’ of jellybeans (p = 0.058). Symptoms occurred in 112 episodes, with a median time to symptom resolution of 12 min (interquartile range (IQR) 8–15 min). Conclusions: Jellybeans are less effective treatment for hypoglycemia than the other three treatments. Glucose tablets, Mentos dragees® and orange juice are of similar efficacy. Treatment with 0.3 g/kg of carbohydrate (excluding jellybeans) effectively resolved hypoglycemia in most children, with 15 min often required to normalize blood glucose.