Hypoglycemia in children and adolescents with type 1 diabetes

Hypoglycemia in children and adolescents with type 1 diabetes is the most frequent acute complication of treatment which can be acutely threatening and lead to immense anxiety and impairment of quality of life for patients and families. The guidelines of the German Working Group Pediatric Diabetes and of the German Diabetes Association recommend 65-70 mg/dl (3.6-3.9 mmol/l) as the threshold for hypoglycemia. Symptoms can be autonomous (adrenergic) reactions as well as neurological dysfunction as a result of neuroglycopenia. Nocturnal hypoglycemia is especially common and can be detected only by frequent self-monitoring of blood glucose (SMBG) or the use of continuous glucose measurement (CGM). Surveillance of risk factors and the use of the optimal insulin regime with the use of short acting insulin analogs, continuous subcutaneous insulin infusion (CSII), CGM and bolus advisors can lower the risk of hypoglycemia.