Effective treatment of hypoglycemia in children with type 1 diabetes: a randomized controlled clinical trial
Open accessAbstract
OBJECTIVE: To determine the most effective of four oral treatments for hypoglycemia in children with type 1 diabetes using a weight-based protocol during diabetes camp. METHODS: During diabetes camp treatment of hypoglycemia was randomized to one of the four treatments, randomly assigned for each episode using a sealed envelope: glucose tablets, jellybeans, orange juice, and sugar mints (Mentos dragees®). An equivalent carbohydrate dose was calculated for each patient for each treatment (0.3 g carbohydrate/kg) and provided to camp leaders. Glucose was measured at 0, 2, 5, 10, and 15 min and symptoms recorded. RESULTS: A total of 191 episodes of hypoglycemia were recorded in 39 children (1-12 episodes per child), with 2 episodes excluded because of protocol violations. Fifty-two episodes were treated with glucose tablets, 45 with jellybeans, 44 with juice, and 48 with sugar mints. Change in glucose at 10 (p = 0.034) and 15 min (p = 0.005) and glucose at 15 min (p = 0.026) were significantly different between treatment groups - jellybeans produced the lowest and slowest response. Glucose tablets did not differ significantly from juice or Mentos dragees. There was a trend for repeat treatment to be required more often with a single treatment 'dose' of jellybeans (p = 0.058). Symptoms occurred in 112 episodes, with a median time to symptom resolution of 12 min (interquartile range (IQR) 8-15 min). CONCLUSIONS: Jellybeans are less effective treatment for hypoglycemia than the other three treatments. Glucose tablets, Mentos dragees® and orange juice are of similar efficacy. Treatment with 0.3 g/kg of carbohydrate (excluding jellybeans) effectively resolved hypoglycemia in most children, with 15 min often required to normalize blood glucose.
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Any form of carbohydrate that contains glucose will raise blood glucose.
“Pure glucose is the preferred treatment, but any form of carbohydrate that contains glucose will raise blood glucose.”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [98]
The acute glycemic response correlates better with the glucose content of food than with the carbohydrate content of food.
“The acute glycemic response correlates better with the glucose content of food than with the carbohydrate content of food.”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [98]
Hypoglycemia treatment requires ingestion of glucose- or carbohydrate-containing foods.
“Hypoglycemia treatment requires ingestion of glucose-or carbohydratecontaining foods (98-100).”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [98]
Real-time CGM studies can be divided into studies with elevated A1C with the primary end point of A1C reduction and studies with A1C near target with the primary end point of reduction in hypoglycemia.
“Real-time CGM studies can be divided into studies with elevated A1C with the primary end point of A1C reduction and studies with A1C near target with the primary end point of reduction in hypoglycemia (98, 109-124).”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [98]
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- Authors
- McTavish, L., & Wiltshire, E.
- Affiliations
- Capital and Coast District Health Board (NZ)
- University of Otago (NZ)
- Corresponding author
- Wiltshire, Esko
- Venue
- Pediatric Diabetes
- Publisher
- Hindawi Limited
- Published
- 2011-03-28
- Volume
- 12
- Issue
- 4pt2
- Pages
- 381-387
- ISSN
- 1399-543X (ISSN-L)
- OpenAlex
- W1976034352
- Cited by
- 58
- References
- 22
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 2 · 2022: 10 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 14 · 2013: 2 · 2012: 1
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- International Society for Pediatric and Adolescent Diabetes
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- hypoglycemia, type 1 diabetes, children, orange juice, diabetes camp, glycemic response, hypoglycemia symptoms
- MeSH terms
- Beverages, Blood Glucose, Candy, Child, Citrus, Diabetes Mellitus, Type 1, Female, Glucose, Humans, Hypoglycemia, Male, Oligosaccharides, Treatment Outcome
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