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Chapter 12: Assessment and management of hypoglycemia in children and adolescents with diabetes
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Dear Members,
Dear Friends,


Hypoglycemia is the common acute complication of type 1 diabetes. It presents a major physiological and psychological barrier to achieving optimal glycemic control and may result in significant emotional morbidity for patients and their caregivers. Although people believe that lower hemoglobin A1C was a risk factor for severe hypoglycemia for years, this association is no longer observed with contemporary therapy in recent surveys. Rates of severe-hypoglycemia – defined as an event with severe cognitive impairment (including coma and convulsions) requiring external assistance by another person to actively administer carbohydrates, glucagon, or take other corrective action - have fortunately reduced worldwide with no association of severe hypoglycemia with improved glycemic control. Therefore, parents and caregivers need to be reassured that good glycemic control can be achieved without severe hypoglycemic events and there is no reason to maintain “high” blood glucose values just to avoid “hypos”. Although young children remain at risk of severe hypoglycemia due to their reduced ability to communicate their need, the incidence of severe hypoglycemic coma has fallen over the last two decades with a current rate of 3 to 7 per 100 patient/years across international registries, mainly due to better treatment options – insulin analogues, insulin pumps and continuous glucose monitoring. Therefore, it is vital to address this important clinical problem during diabetes education and management.
 
To know more about hypoglycemia: what it is, what are its symptoms, treatment, the effect on the developing brain – you must read a very comprehensive ISPAD Guidelines chapter: Assessment and management of hypoglycemia in children and adolescents with diabetes. You can find it here.

Check also the ISPAD resource platform and watch the lecture about Acute Complications: Hypoglycaemia and brain development in toddlers by Ana Maria Arbelaez and Eli Lilly's symposium on Hypoglycaemia: Who’s afraid of Hypoglycemia? Partnering to Provide Confidence to Patients and Caregivers  or Hypoglycemia in Diabetes: incidence and clinical implications - what is the data telling us? by Dick Mul.


The Conference Resource Platform has been made possible thanks to an independent educational sponsorship from

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If you have any questions, please contact:

ISPAD Conference Secretariat
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Fax: +49 30 24 60 3-200
 
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