Hypoglycaemic symptoms reported by children with Type 1 diabetes mellitus and by their parents

• Published in: Diabetic medicine Vol. 15; no. 10; pp. 836 - 843
• Main Authors: Ross, L.A., McCrimmon, R.J., Frier, B.M., Kelnar, C.J.H., Deary, I.J.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-10-1998; Blackwell
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; children; Diabetes Mellitus, Type 1 - complications; Drug toxicity and drugs side effects treatment; factor analysis; Factor Analysis, Statistical; Humans; hypoglycaemia; Hypoglycemia - epidemiology; Hypoglycemia - etiology; Hypoglycemia - prevention & control; Incidence; Medical sciences; Miscellaneous (drug allergy, mutagens, teratogens...); Parenting; Patient Education as Topic; Pharmacology. Drug treatments; Surveys and Questionnaires; symptoms; Type 1 diabetes; United Kingdom - epidemiology; United Kingdom; Europe; Endocrinopathy; Human; Immunopathology; Pancreatic hormone; Factor analysis; Self evaluation; Parent; Toxicity; Autoimmune disease; Health education; Hypoglycemia; Insulin; Protein hormone; Symptomatology; Adolescent; Insulin dependent diabetes; Adult; Child; Comparative study
• ISSN: 0742-3071; 1096-9136; 1464-5491
• DOI: 10.1002/(SICI)1096-9136(199810)15:10<836::AID-DIA681>3.0.CO;2-S

To compare the hypoglycaemic symptoms reported by children with Type 1 diabetes and signs observed by and symptoms reported to their parents, 101 pairs, consisting of a child with diabetes and one of their parents, were asked to report the frequency with which they experienced, or witnessed, each of 31 symptoms during hypoglycaemia. The hypoglycaemic symptoms reported by the children and the reported symptoms and signs observed by their parents were classified, using multivariate statistical analyses, and compared. Close agreement was observed between the children and their respective parents’ scores for frequencies of most symptoms/signs, as demonstrated by Spearman’s rank correlations (median τs = 0.25, p < 0.02). Principal Components Analysis of the symptoms/signs observed by the parents showed three factors: autonomic, neuroglycopenic, and behavioural disturbance. Analysis of the symptoms experienced by the children also identified three factors: behavioural disturbance, malaise and a third factor consisting of a combination of autonomic and neuroglycopenic symptoms. The parents could differentiate three separate groups of reported hypoglycaemic symptoms and signs (autonomic, neuroglycopenic, and behavioural disturbance) in their children. The children reported a similar group of behavioural symptoms but did not discriminate between autonomic and neuroglycopenic symptoms. These findings have important implications for the education of parents and children with Type 1 diabetes regarding the symptoms and signs of hypoglycaemia. © 1998 John Wiley & Sons, Ltd.