Long-term follow-up of insulin-dependent diabetes mellitus patients with recurrent episodes of severe hypoglycaemia

We conducted a long-term clinical follow-up of 20 insulin-treated diabetic patients with the problem of repeated severe hypoglycaemic events, identifi ed during 1982-1984. Furthermore, we investigated the reproducibility of a standardized insulin-infusion test among eight of these patients and 10 ins ulin-dependent diabetes mellitus patients without the problem of severe hyp oglycaemia. At start of the follow-up, the patients were characterized, whi ch revealed that proposed risk factors for severe hypoglycaemia were very c ommon and that at least one predisposing factor was present in all patients . No fatal episode of hypoglycaemia occurred in this group of patients duri ng the follow-up. Emergency visits due to hypoglycaemia decreased during th e follow-up from 1.05 year(-1) in 1982-1984 to 0.42 year(-1) in 1992-1994 ( P = 0.024). No association to HbA1c was seen (P = 0.11). A correlation with the change to multiple insulin regimen was seen with a incidence of 1.27 y ear(-1) before the change to 0.47 year(-1) after (P = 0.003). The glucose r esponse to an insulin-infusion test appeared reproducible among the patient s with recurrent attacks of severe hypoglycaemia. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.