High incidence of hypoglycemic episodes with neurologic manifestations in children with insulin dependent diabetes mellitus

Hypoglycemia is a serious frequent complication of insulin therapy in type 1 diabetes. Patients and Methods: We surveyed 139 IDDM patients. Results: Forty-four patients (32%) reported at least one severe hypoglycemic episode. All patients with severe hypoglycemia experienced neurological manifestations. Symptoms included confusion and abnormal behavior, convulsions, coma, transient hemisparesis and one case of permanent hemiparesis. Most episodes occurred at night or during morning hours. 44% of episodes were related to delayed meal or snack, 11% to excess insulin administration and 13% to extra physical activity. HbA(1c) was significantly lower in patients with severe hypoglycemia compared with diabetic controls (7.33 ± 1.09% and 9.45 ± 4.32%, respectively).