Abstract
In adults with insulin-treated diabetes, hypoglycemia-associated autonomic failure (HAAF) is described as a syndrome that includes counterregulatory hormonal deficiencies and impaired symptomatic awareness in response to severe hypoglycemia (1). It is thought to result from failure of the central autonomic response to acute neuroglycopenia and is associated with recurrent exposure to hypoglycemia and increasing duration of diabetes. It is not known whether this syndrome occurs in children with type 1 diabetes, but the Diabetes Research in Children Network (DirecNet) Study Group has claimed that HAAF was present in at least a third of their participants with type 1 diabetes (2). Examination of the study design and methodology raises …
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