December 23, 2013

Hypo in Preschool

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pediatricWhether your child is in high school or preschool, no parent wants their child to have a hypoglycemic event. The study was published in Pediatric Diabetes disclosing the rate of hypoglycemia of kids in preschool, , based on insulin type.

In the study, 125 kids aged 6 and younger were followed with a CGM. These children were treated with basal insulin injections of either Lantus or NPH.

Hypoglycemic events were considered to be a reading on the CGM or a finger stick of 3.9 mmol/L. That’s about 70 mg/dL. For a kid in preschool, that’s too low.

At the start of the study, baseline A1c was taken for each group. Lantus kids were 8.0% and NPH kids were 8.2%. The correlation for hypoglycemic events, per 100 kids was 1.93 for Lantus and 1.69 for NPH.

The opportunity cost for a rate of fewer low blood sugars is a trade-off . Lantus kids received once-daily injections whereas the NPH kids received twice-daily injections. Remeber the Lantus kids had an A1c .2% lower than the NPH kids.

The Lantus and NPH  treatment protocols have pros and cons. If you had a choice, you wouldn’t want more low blood sugars in you day. Given the choice of one injection instead of two, you might choose the former. Diabetes is the lesser of two evils.

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