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Fear and other disturbances of severe hypoglycaemia in children and adolescents with type 1 diabetes mellitus
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
2005 (English)In: Journal of Pediatric Endocrinology & Metabolism (JPEM), ISSN 0334-018X, Vol. 18, no 1, 83-91 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To study perceived occurrence and magnitude of fear and other disturbances of severe hypoglycaemia in children and adolescents with type 1 diabetes mellitus (DM) receiving intensive treatment with active education and psychosocial support. Patients and Methods: Out of a geographic population of 112 patients <19 years of age and their families, with a DM duration >1 year, HbA1c mean ± SD 6.7 ± 0.9 (method 1.15% below DCCT level), 74 responded to a questionnaire. Visual analogue scales, 5-graded Likert scales and open questions were used. Results: Global quality of life was high, but lower among patients with severe hypoglycaemia within the last year (p = 0.0114). Worse perceived health was correlated to higher HbA1c year mean (r = 0.32, p = 0.0227). Patients and parents regard severe hypoglycaemia more as a problem (p <0.0001) and the risk of it more disturbing than mild hypoglycaemia (p <0.0001), insulin injections (p <0.0001) or blood glucose determinations (p <0.0001). The disturbance is higher during exercise, disco/party and in travel situations. Severe hypoglycaemia with unconsciousness causes more fear than severe hypoglycaemia needing assistance but without unconsciousness (p = 0.0001 or the potential late complications of DM (p = 0.0014). Severe hypoglcaemia needing assistance but without unconsciousness causes more fear than mild hypoglycaemia (p = 0.0001) and diabetic ketoacidosis (p <0.0001) but less than the potential late complications of DM (p = 0.0034). Conclusions: Severe hypoglycaemia frequently causes fear and various disturbances in spite of active education and psychosocial support. There is a potential for increased quality of life from interventions targeted at the prevention of severe hypoglycaemia. Further research and improved strategies for the prevention of severe hypoglycaemia are needed.

Place, publisher, year, edition, pages
2005. Vol. 18, no 1, 83-91 p.
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-24489Local ID: 6612OAI: oai:DiVA.org:liu-24489DiVA: diva2:244810
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-12

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Nordfeldt, SamLudvigsson, Johnny

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Faculty of Health SciencesChild and Adolescent PsychiatryPediatricsDepartment of Paediatrics in Linköping
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