RT Journal Article
SR Electronic
T1 Cognitive function and mood after profound nocturnal hypoglycaemia in prepubertal children with conventional insulin treatment for diabetes
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 138
OP 142
DO 10.1136/adc.81.2.138
VO 81
IS 2
A1 K A Matyka
A1 L Wigg
A1 S Pramming
A1 G Stores
A1 D B Dunger
YR 1999
UL http://adc.bmj.com/content/81/2/138.abstract
AB OBJECTIVES To examine the frequency of nocturnal hypoglycaemia, and the effects on cognitive function and mood, in children with insulin dependent diabetes mellitus (IDDM). DESIGN Two 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. RESULTS Asymptomatic 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. CONCLUSIONS Young 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.