Parents often miss low blood sugar in diabetic kids

Children with type 1 diabetes have a difficult time recognizing warning signs that their blood sugar has fallen to dangerously low levels, and their parents do even worse, a new study demonstrates.

In a 7-month study, researchers found that parents missed 54 percent of instances when a child had moderate "hypoglycemia," or low blood sugar, while kids missed 41 percent of these episodes.

Hypoglycemia is an "inevitable" consequence of insulin treatment, Dr. Linda Gonder-Frederick of the University of Virginia in Charlottesville, told Reuters Health. Severe hypoglycemia can have harmful consequences, she pointed out, including disorientation, unconsciousness and even seizures.

Gonder-Frederick and her team had 61 children, 6 to 11 years old, and their parents rate hypoglycemia symptoms, estimate the child's blood sugar level, and measure it using a survey programmed on a personal digital assistant. The study participants completed 70 trials of the survey over a month, and then reported episodes of severe hypoglycemia for the next six months.

Blood sugar estimates by both parents and children were accurate less than one-third of the time, the team found. Parents made mistakes that could have harmful consequences in 23 percent of cases - for example, thinking that a child had high blood sugar when it was actually low, while 27 percent of children's estimates represented potentially harmful mistakes.

"Parents and children in general are not provided with enough patient education about hypoglycemia and its impact on the body, especially the central nervous system," Gonder-Frederick noted. When their brains aren't getting enough glucose (sugar), she explained, children can lose control over their behavior, which may look like misbehavior to their parents.

According to the researcher, parents and their diabetic children can find good information on low blood sugar and how to cope with it from Childrenwithdiabetes.com, the American Diabetes Association, and the Juvenile Diabetes Research Foundation.

SOURCE: Pediatrics, March 2008.