Children with type 1 diabetes have a difficult time recognising warning signs that their blood sugar has fallen to dangerously low levels, and their parents do even worse, a new study demonstrates.
In a 7-month study, researchers found that parents missed 54 percent of instances when a child had moderate "hypoglycaemia," or low blood sugar, while kids missed 41 percent of these episodes.
Hypoglycaemia is an "inevitable" consequence of insulin treatment, Dr Linda Gonder-Frederick of the University of Virginia in Charlottesville, told Reuters Health. Severe hypoglycaemia can have harmful consequences, she pointed out, including disorientation, unconsciousness and even seizures.
Gonder-Frederick and her team had 61 children, 6 to 11 years old, and their parents rate hypoglycaemia symptoms, estimate the child's blood sugar level, and measure it using a survey programmed on a personal digital assistant. The study participants completed 70 trials of the survey over a month, and then reported episodes of severe hypoglycaemia for the next six months.
Misjudgement could be harmful
Blood sugar estimates by both parents and children were accurate less than one-third of the time, the team found. Parents made mistakes that could have harmful consequences in 23 percent of cases - for example, thinking that a child had high blood sugar when it was actually low, while 27 percent of children's estimates represented potentially harmful mistakes.
"Parents and children in general are not provided with enough patient education about hypoglycaemia and it's impact on the body, especially the central nervous system," Gonder-Frederick noted. When their brains aren't getting enough glucose (sugar), she explained, children can lose control over their behaviour, which may look like misbehaviour to their parents. – (Anne Harding/Reuters Health)
SOURCE: Pediatrics, March 2008.
Diabetes and adolescents