BACKGROUND:Hypoglycemia is a common complication of insulin therapy in patients with Type 1 Diabetes Mellitus (DM). Awareness of hypoglycemic symptoms helps patients to recognize hypoglycemia and initiate self-treatment. Impaired Awareness of Hypoglycemia (IAH) exposes patients to severe hypoglycemia, which could be associated with seizures and unconsciousness. This study aimed to assess IAH, frequency of hypoglycemia, severe hypoglycemia and intensity of hypoglycemic symptoms among children and adolescents with Type 1 DM in North of Jordan. METHODS:Data were collected from 94 children and adolescents with Type 1 DM. Clarke's and Edinburgh surveys were used to assess IAH and individual symptoms of hypoglycemia, respectively. Frequency of hypoglycemia and other related information were obtained by self-reporting or from medical records. RESULTS:16.0% of participants were having IAH, 66.0% of participants reported recurrent hypoglycemia (>once/month) and 18.0% of participants developed ≥1 severe hypoglycemia during the previous year. IAH was not associated with age, gender, duration of DM, HbA1c, insulin regimen, adherence to insulin or development of severe hypoglycemia (p-values> 0.05). Instead, IAH was associated with frequency of hypoglycemia during the previous 6 months (p-value< 0.01). Hunger, tiredness, dizziness, drowsiness, inability to concentrate, trembling and weakness were the most common symptoms felt by participants when they develop hypoglycemia. Hunger was the only common symptom that was significantly higher in children compared to adolescent (p-value < 0.01). CONCLUSIONS:This study has reported low prevalence of IAH in children and adolescents with Type 1 DM in North of Jordan. IAH was more common in subjects with more frequent hypoglycemia.

译文

背景:低血糖症是1型糖尿病(DM)患者胰岛素治疗的常见并发症。意识到降血糖症状有助于患者识别低血糖症并开始自我治疗。低血糖意识(IAH)受损使患者暴露于严重的低血糖症中,这可能与癫痫发作和神志不清有关。这项研究旨在评估约旦北部患有1型DM的儿童和青少年的IAH,低血糖发生率,严重低血糖症和降血糖症状的强度。
方法:收集了94例1型糖尿病儿童和青少年的数据。 Clarke和爱丁堡的调查分别用于评估IAH和低血糖的个体症状。低血糖发生频率和其他相关信息可通过自我报告或从医疗记录中获得。
结果:16.0%的受试者患有IAH,66.0%的受试者报告反复低血糖(>一次/月),并且18.0%的受试者在上一年出现≥1的严重低血糖。 IAH与年龄,性别,DM持续时间,HbA1c,胰岛素治疗方案,胰岛素依从性或严重低血糖的发生无关(p值> 0.05)。相反,IAH与前6个月的低血糖发生率相关(p值结论:该研究报告了约旦北部患有1型DM的儿童和青少年中IAH的患病率较低。 IAH在低血糖症患者中更为常见。

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