SYMPTOMATIC HYPOGLYCEMIA IN CHILDREN AND ADOLESCENTS WITH TYPE-1 DIABETES-MELLITUS IN SUDAN

Objectives: to determine the prevalence of symptomatic hypoglycemia, i ts perceived causes and its relationship to metabolic control in young diabetic Sudanese patients. Design: Prospective Cohort Study subjects : Eighty-four patients below the age of 20 with type I (insulin-depend ent) diabetes mellitus attending the diabetes center at the University Hospital in Khartoum. Results: Although the glycemic control of this group of patients was poor (average HbAlc = 12.6%), 48 children of the 76 patients who completed the trial experienced 227 attacks over a pe riod of 28 weeks. Palpitations and tremors were the most common initia l symptoms reported by half of the patients, followed by dizziness, hu nger and headache. The main precipitating factors of the episodes were : missed meals, wrong insulin dose and physical exercise. The majority of the episodes were mild reactions and only 29 (12.8%) were severe. Of the latter group, two episodes were associated with seizures, 5 pat ients went into coma, 3 episodes ended with motor aphasia and one pati ent died. No significant associations were found between the average g lycated hemoglobin concentration and the frequency or severity of hypo glycemia in this group of patients. Conclusions: Poor metabolic contro l is not a safeguard against hypoglycemia in diabetic children and ado lescents.