Prospective Assessment of Hypoglycemia Symptoms in Children and Adults with Type 1 Diabetes

Purpose: To compare the characteristics of symptoms of hypoglycemia in children and in adults with type 1 diabetes. Methods: Adults with diabetes and parents of children with diabetes who were participants were asked to call a phone system to report episodes of hypoglycemia (presence of symptoms and a blood glucose <4.0 mmol/L). For each episode, blood glucose reading and a scoring of 28 symptoms on a 7-point scale (1 = not present, 7 = very intense) were collected. Results: Sixty six children (49.2% males, mean age = 12.1 +/- 2.4 years, mean age at diagnosis = 7.5 +/- 2.9 years) and 53 adults (41.2% males, mean age 38.7 +/- 14.5 years, mean age at diagnosis = 17.5 +/- 12.9 years) with type 1 diabetes participated. The most common symptoms in adults were hunger, sweating, trembling and weakness. The most common symptoms in children were weakness, trembling and hunger. The 2 most discriminating variables between children and adults were sleepiness and tiredness, which were more common in children (p<0.01). In a comparative factor analysis, 3 factors emerged: factor 1, autonomic and neuroglycopenic; factor 2, behavioural; and factor 3, general malaise. Factors 2 and 3 were significantly more common or intense in children than in adults; MANOVA: F(1,113) = 6.72, p<0.05 and F(1,113) = 4.64, p<0.05, respectively. Conclusions: Symptoms relating to behaviour and general malaise are more common in children than in adults with type 1 diabetes. The results of this study may assist providers in educating caregivers of children and patients with diabetes how to better recognize episodes of hypoglycemia. (C) 2014 Canadian Diabetes Association