Abstract
We assessed hypoglycemic symptoms in 29 children aged 15.4±2.4 yrs (x±SD) with IDD duration 7.9±3.7 yrs without clinical autonomic neuropathy. An intravenous insulin bolus of 0.15-0.75 u/kg according to basal plasma glucose (PG) was given before and again after 3 days of intensive insulin therapy (IIT). Oral questionnaires regarding hypoglycemic (H) symptoms were completed at each time blood samples were taken for measurements of PG and CATS. An hypoglycemic awareness score (HAS) was assigned to each patient. All but 1 patient reported symptoms during each test. These occurred prior to H(PG> 65 mg%) in 73% before and 52% after IIT. The initial symptoms (usually hunger) appeared at 38±26 min before and 35±18 min after IIT after PG decrements of 121±81 (47±23%) and 88±64 mg% (46±26%) resp. (NS). The CAT increments at this time were very small (174±55, range 0-802 and 70±89, 0-262 pg/ml resp.). The max HAS correlated negatively with PG nadir, before (r=-.69, p 250 pg/ml. Thus, H unawarcness is not common in children with IDD & symptoms occur prior to onset of H with minimal if any CAT increments.
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