Arch Dis Child 1999;81:138-142 ( August )

Cognitive function and mood after profound nocturnal hypoglycaemia in prepubertal children with conventional insulin treatment for diabetes

K A Matyka^a, L Wigg^b, S Pramming^c, G Stores^b, D B Dunger^a

^a Department of Paediatrics, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK, ^b University Section of Child and Adolescent Psychiatry, Park Hospital for Children, Headington, Oxford OX3 7LQ, UK, ^c Diabetes Care, Novo Nordisk, Building 9Q 2.04, Novo Alle 2880, Bagsvaerd, Denmark

Correspondence to: Dr Dunger.

Accepted 8 March 1999

OBJECTIVESTo examine the frequency of nocturnal hypoglycaemia, and the effects on cognitive function and mood, in children with insulin dependent diabetes mellitus (IDDM).
DESIGNTwo overnight glucose profiles, in the home environment, and assessments of cognitive function and mood the following day. Twenty nine prepubertal patients with IDDM (median age, 9.4 years; range, 5.3-12.9) and 15 healthy controls (single overnight profile), median age 9.5 (range, 5.6-12.1) years were studied.
RESULTSAsymptomatic hypoglycaemia (glucose < 3.5 mmol/l) was observed in 13 of 29 patients studied on night 1: four of these and seven others were hypoglycaemic on night 2. The median glucose nadir was 1.9 (range, 1.1-3.3) mmol/l and the median duration of hypoglycaemia was 270 (range, 30-630) minutes. Hypoglycaemia was related to insulin dose, but not glycosylated haemoglobin (HbA1c) values, and was partially predicted by a midnight glucose of < 7.2 mmol/l. Cognitive performance was not altered after hypoglycaemia but a lowering of mood was observed.
CONCLUSIONSYoung children on conventional insulin regimens are at high risk for profound, asymptomatic nocturnal hypoglycaemia, which is difficult to predict. There was no short term effect on cognitive function but mood change was detected.


Keywords: nocturnal hypoglycaemia; mood; cognitive function; insulin dependent diabetes mellitus

---

© 1999 by Archives of Disease in Childhood
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Kodl, C. T., Seaquist, E. R. (2008). Cognitive Dysfunction and Diabetes Mellitus. Endocr. Rev. 29: 494-511 [Abstract] [Full Text]  
• Shalitin, S., Phillip, M. (2008). Hypoglycemia in Type 1 Diabetes: A still unresolved problem in the era of insulin analogs and pump therapy. Diabetes Care 31: S121-S124 [Abstract] [Full Text]  
• Cameron, F. J., Northam, E. A., Ambler, G. R., Daneman, D. (2007). Routine Psychological Screening in Youth With Type 1 Diabetes and Their Parents: A notion whose time has come?. Diabetes Care 30: 2716-2724 [Full Text]  
• Tkacs, N. C., Thompson, H. J. (2006). From bedside to bench and back again: research issues in animal models of human disease.. Biol Res Nurs 8: 78-88 [Abstract]  
• Raju, B., Arbelaez, A. M., Breckenridge, S. M., Cryer, P. E. (2006). Nocturnal Hypoglycemia in Type 1 Diabetes: An Assessment of Preventive Bedtime Treatments. J. Clin. Endocrinol. Metab. 91: 2087-2092 [Abstract] [Full Text]  
• Hathout, E., Patel, N., Southern, C., Hill, J., Anderson, R., Sharkey, J., Hadley-Scofield, M., Tran, L., Leptien, A., Lopatin, M., Wang, B., Mace, J., Eastman, R. (2005). Home Use of the GlucoWatch G2 Biographer in Children With Diabetes. Pediatrics 115: 662-666 [Abstract] [Full Text]  
• Hathout, E, Lakey, J, Shapiro, J (2003). Islet transplant: an option for childhood diabetes?. Arch. Dis. Child. 88: 591-594 [Abstract] [Full Text]  
• Murphy, N. P., Keane, S. M., Ong, K. K., Ford-Adams, M., Edge, J. A., Acerini, C. L., Dunger, D. B. (2003). Randomized Cross-Over Trial of Insulin Glargine Plus Lispro or NPH Insulin Plus Regular Human Insulin in Adolescents With Type 1 Diabetes on Intensive Insulin Regimens. Diabetes Care 26: 799-804 [Abstract] [Full Text]  
• McCarthy, A. M., Lindgren, S., Mengeling, M. A., Tsalikian, E., Engvall, J. (2003). Factors Associated With Academic Achievement in Children With Type 1 Diabetes. Diabetes Care 26: 112-117 [Abstract] [Full Text]  
• Cryer, P. E., Childs, B. P. (2002). Negotiating the Barrier of Hypoglycemia in Diabetes. Diabetes Spectr. 15: 20-27 [Abstract] [Full Text]