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Treatment of mild-to-moderate hypoglycemia in patients with type-1 diabetes.

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eMediNexus Editorial    13 December 2017

Mild-to-moderate hypoglycemia (blood glucose < 4.0 mmol/L) is recommended to be treated with 15 g of carbohydrates and to repeat the treatment if hypoglycemia persists after 15 min. This recommendation was established before intensive insulin therapy.

A new study published in Acta Diabetologica explored the effect of current recommended treatment of mild-to-moderate hypoglycemia in type-1 diabetes (T1D) patients, and factors associated with its effectiveness.

This was a secondary analysis from three observational inpatient studies with a standardized and supervised treatment (16 g carbohydrates) of hypoglycemia (< 3.3 mmol/L with symptoms or < 3.0 mmol/L without symptom) in 47 adults and 10 adolescents with T1D, using continuous subcutaneous insulin infusion (CSII).

The results showed that overall, 27 participants presented with 48 hypoglycemic episodes, and were treated by a single intake of 16 g of carbohydrates. Meanwhile, the time required for recovery to normoglycemia was 19.5 ± 12.0 min and the increase in plasma-glucose following treatment was 0.85 ± 0.66 mmol/L in 15 min. Furthermore, 18 episodes were resolved, 15 minutes post-treatment. On the other hand, glycemia at the time of treatment and a higher proportion of total daily insulin from basal doses were associated with a slower post-treatment plasma glucose rise.

The findings suggested that a higher likelihood of sixteen grams of carbohydrates being insufficient to treat a large proportion of hypoglycemia episodes in T1D patients treated with CSII.

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