Response to hypo- and hyperglycemia in adolescents with type I diabetes

Objective: To assess the appropriateness of adolescents' responses to hypo- and hyperglycemia and to examine the relationship of patient age, gender, diabetes duration, diabetes knowledge, parental supervision, and glycemic c ontrol to response appropriateness. Methods: We assessed 125 adolescents' responses to daily episodes of hypo- and hyperglycemia by 24-hour recall interviews; responses were coded for ty pe and appropriateness. Results: Adolescents responded inappropriately to 38% of hypoglycemic and 2 9% of hyperglycemic episodes. Parental supervision of blood glucose testing did not increase the likelihood of an appropriate response; in the case of hyperglycemic episodes, it appear;ed to be counterproductive. Adolescents who responded inappropriately to hyperglycemia were also older but not diff erent from those who responded appropriately by gender, disease duration, d iabetes knowledge, or glycemic control. Conclusions: Health providers and family members may underestimate adolesce nts' difficulty managing hypo- and hyperglycemia appropriately. The presenc e of parental supervision does not ensure an appropriate response; parents may be particularly misinformed about the management of hyperglycemia.