ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes

Pediatric Diabetes - Tập 19 - Trang 178-192 - 2018
Mary B. Abraham1,2,3, Timothy W. Jones1,2,3, Diana Naranjo4, Beate Karges5, Abiola Oduwole6, Martin Tauschmann7, David M. Maahs4
1Children’s Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
2Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, Australia
3Division of Paediatrics; Medical School, The University of Western Australia; Perth Australia
4Division of Endocrinology, Department of Pediatrics; Stanford University School of Medicine; Stanford California
5Division of Endocrinology and Diabetes, Medical Faculty, RWTH Aachen University, Aachen, Germany
6College of Medicine, University of Lagos, Nigeria
7Wellcome Trust-MRC Institute of Metabolic Science, Department of Paediatrics; University of Cambridge; Cambridge UK

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Cryer, 2008, Hypoglycemia: still the limiting factor in the glycemic management of diabetes, Endocr Pract, 14, 750, 10.4158/EP.14.6.750

Haynes, 2017, Severe hypoglycemia rates are not associated with HbA1c: a cross-sectional analysis of 3 contemporary pediatric diabetes registry databases, Pediatr Diabetes, 18, 643, 10.1111/pedi.12477

American Diabetes Association, 2017, Standards of Medical Care in Diabetes-2017 Abridged for Primary Care Providers, Clin Diabetes, 35, 5, 10.2337/cd16-0067

Hopkins, 2012, Improved biomedical and psychological outcomes 1 year after structured education in flexible insulin therapy for people with type 1 diabetes: the U.K. DAFNE experience, Diabetes Care, 35, 1638, 10.2337/dc11-1579

Abraham, 2018, Reduction in hypoglycemia with the predictive low-glucose management system: a long-term randomized controlled trial in adolescents with type 1 diabetes, Diabetes Care, 41, 303, 10.2337/dc17-1604

Battelino, 2017, Prevention of hypoglycemia with predictive low glucose insulin suspension in children with type 1 diabetes: a randomized controlled trial, Diabetes Care, 40, 764, 10.2337/dc16-2584

Ly, 2013, Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial, JAMA, 310, 1240, 10.1001/jama.2013.277818

Bergenstal, 2013, Threshold-based insulin-pump interruption for reduction of hypoglycemia, N Engl J Med, 369, 224, 10.1056/NEJMoa1303576

Weisman, 2017, Effect of artificial pancreas systems on glycaemic control in patients with type 1 diabetes: a systematic review and meta-analysis of outpatient randomised controlled trials, Lancet Diabetes Endocrinol, 5, 501, 10.1016/S2213-8587(17)30167-5

Johnson, 2013, Hypoglycaemia, fear of hypoglycaemia and quality of life in children with type 1 diabetes and their parents, Diabet Med, 30, 1126, 10.1111/dme.12247

Rewers, 2014, ISPAD Clinical Practice Consensus Guidelines 2014. Assessment and monitoring of glycemic control in children and adolescents with diabetes, Pediatr Diabetes, 15, 102, 10.1111/pedi.12190

Phelan, 2017, The Australasian diabetes data network: first national audit of children and adolescents with type 1 diabetes, Med J Aust, 206, 121, 10.5694/mja16.00737

Fredheim, 2015, Nationwide reduction in the frequency of severe hypoglycemia by half, Acta Diabetol, 52, 591, 10.1007/s00592-014-0697-5

Karges, 2014, Hemoglobin A1c levels and risk of severe hypoglycemia in children and young adults with type 1 diabetes from Germany and Austria: a trend analysis in a cohort of 37,539 patients between 1995 and 2012, PLoS Med, 11, e1001742, 10.1371/journal.pmed.1001742

O'Connell, 2011, Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000-2009, Diabetes Care, 34, 2379, 10.2337/dc11-0748

Cooper, 2013, A population-based study of risk factors for severe hypoglycaemia in a contemporary cohort of childhood-onset type 1 diabetes, Diabetologia, 56, 2164, 10.1007/s00125-013-2982-1

American Diabetes Association, 2015, Minimizing hypoglycemia in diabetes, Diabetes Care, 38, 1583, 10.2337/dc15-0279

American Diabetes Association, 2017, Glucose concentrations of less than 3.0 mmol/L (54 mg/dL) should be reported in clinical trials: a joint position statement of the American Diabetes Association and the European Association for the Study of Diabetes, Diabetes Care, 40, 155, 10.2337/dc16-2215

Jones, 2018, Defining relevant hypoglycemia measures in children and adolescents with type 1 diabetes, Pediatr Diabetes, 19, 354, 10.1111/pedi.12600

Amiel, 1988, Effect of intensive insulin therapy on glycemic thresholds for counterregulatory hormone release, Diabetes, 37, 901, 10.2337/diab.37.7.901

Boyle, 1988, Plasma glucose concentrations at the onset of hypoglycemic symptoms in patients with poorly controlled diabetes and in nondiabetics, N Engl J Med, 318, 1487, 10.1056/NEJM198806093182302

Cryer, 2013, Mechanisms of hypoglycemia-associated autonomic failure in diabetes, N Engl J Med, 369, 362, 10.1056/NEJMra1215228

Mitrakou, 1991, Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction, Am J Phys, 260, E67

Schwartz, 1987, Glycemic thresholds for activation of glucose counterregulatory systems are higher than the threshold for symptoms, J Clin Invest, 79, 777, 10.1172/JCI112884

Seaquist, 2013, Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society, Diabetes Care, 36, 1384, 10.2337/dc12-2480

Katz, 2012, Contemporary rates of severe hypoglycaemia in youth with type 1 diabetes: variability by insulin regimen, Diabet Med, 29, 926, 10.1111/j.1464-5491.2012.03646.x

Svoren, 2007, Temporal trends in the treatment of pediatric type 1 diabetes and impact on acute outcomes, J Pediatr, 150, 279, 10.1016/j.jpeds.2006.12.009

The Diabetes Control and Complications Trial Research Group, 1997, Hypoglycemia in the Diabetes Control and Complications Trial, Diabetes, 46, 271, 10.2337/diab.46.2.271

Bulsara, 2004, The impact of a decade of changing treatment on rates of severe hypoglycemia in a population-based cohort of children with type 1 diabetes, Diabetes Care, 27, 2293, 10.2337/diacare.27.10.2293

Rewers, 2002, Predictors of acute complications in children with type 1 diabetes, JAMA, 287, 2511, 10.1001/jama.287.19.2511

Davis, 1997, Hypoglycemia: incidence and clinical predictors in a large population-based sample of children and adolescents with IDDM, Diabetes Care, 20, 22, 10.2337/diacare.20.1.22

Mortensen, 1997, Comparison of metabolic control in a cross-sectional study of 2,873 children and adolescents with IDDM from 18 countries. The Hvidore Study Group on childhood diabetes, Diabetes Care, 20, 714, 10.2337/diacare.20.5.714

Karges, 2017, Glycated hemoglobin A1c as a risk factor for severe hypoglycemia in pediatric type 1 diabetes, Pediatr Diabetes, 18, 51, 10.1111/pedi.12348

Maahs, 2014, Contrasting the clinical care and outcomes of 2,622 children with type 1 diabetes less than 6 years of age in the United States T1D exchange and German/Austrian DPV registries, Diabetologia, 57, 1578, 10.1007/s00125-014-3272-2

Birkebaek, 2017, Incidence of severe hypoglycemia in children with type 1 diabetes in the Nordic countries in the period 2008-2012: association with hemoglobin A1c and treatment modality, BMJ Open Diabetes Res Care, 5, e000377, 10.1136/bmjdrc-2016-000377

Johansen, 2015, Prevalence and predictors of severe hypoglycemia in Danish children and adolescents with diabetes, Pediatr Diabetes, 16, 354, 10.1111/pedi.12171

Samann, 2005, Glycaemic control and severe hypoglycaemia following training in flexible, intensive insulin therapy to enable dietary freedom in people with type 1 diabetes: a prospective implementation study, Diabetologia, 48, 1965, 10.1007/s00125-005-1905-1

Khunti, 2016, Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes: the global HAT study, Diabetes Obes Metab, 18, 907, 10.1111/dom.12689

Cryer, 2012, Severe hypoglycaemic predicts mortality in diabetes, Diabetes Care, 35, 1814, 10.2337/dc12-0749

Tanenberg, 2010, Confirmation of hypoglycemia in the "dead-in-bed" syndrome, as captured by a retrospective continuous glucose monitoring system, Endocr Pract, 16, 244, 10.4158/EP09260.CR

Chow, 2017, Cardiac autonomic regulation and repolarization during acute experimental hypoglycemia in type 2 diabetes, Diabetes, 66, 1322, 10.2337/db16-1310

Novodvorsky, 2017, Diurnal differences in risk of cardiac arrhythmias during spontaneous hypoglycemia in young people with type 1 diabetes, Diabetes Care, 40, 655, 10.2337/dc16-2177

Pistrosch, 2015, Risk of and risk factors for hypoglycemia and associated arrhythmias in patients with type 2 diabetes and cardiovascular disease: a cohort study under real-world conditions, Acta Diabetol, 52, 889, 10.1007/s00592-015-0727-y

Patterson, 2007, Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989, Diabetologia, 50, 2439, 10.1007/s00125-007-0824-8

Feltbower, 2008, Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire register of diabetes in children and young adults, Diabetes Care, 31, 922, 10.2337/dc07-2029

Skrivarhaug, 2006, Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway, Diabetologia, 49, 298, 10.1007/s00125-005-0082-6

Wasag, 2018, Excess all-cause mortality before age 30 in childhood onset type 1 diabetes: data from the Brecon group cohort in Wales, Arch Dis Child, 103, 44, 10.1136/archdischild-2016-312581

Gagnum, 2017, Causes of death in childhood-onset Type 1 diabetes: long-term follow-up, Diabet Med, 34, 56, 10.1111/dme.13114

Tu, 2008, Causes of death in young Australians with type 1 diabetes: a review of coronial postmortem examinations, Med J Aust, 188, 699, 10.5694/j.1326-5377.2008.tb01849.x

Marques, 1997, Altered ventricular repolarization during hypoglycaemia in patients with diabetes, Diabet Med, 14, 648, 10.1002/(SICI)1096-9136(199708)14:8<648::AID-DIA418>3.0.CO;2-1

Weston, 1999, Is undetected autonomic dysfunction responsible for sudden death in Type 1 diabetes mellitus? The 'dead in bed' syndrome revisited, Diabet Med, 16, 626, 10.1046/j.1464-5491.1999.00121.x

Lo, 1993, Information on type 1 diabetes mellitus and QT interval from identical twins, Am J Cardiol, 72, 305, 10.1016/0002-9149(93)90677-5

Tu, 2010, Sudden death in type 1 diabetes: the mystery of the 'dead in bed' syndrome, Int J Cardiol, 138, 91, 10.1016/j.ijcard.2008.06.021

Ryan, 2006, Why is cognitive dysfunction associated with the development of diabetes early in life? The diathesis hypothesis, Pediatr Diabetes, 7, 289, 10.1111/j.1399-5448.2006.00206.x

Gonder-Frederick, 2009, Cognitive function is disrupted by both hypo- and hyperglycemia in school-aged children with type 1 diabetes: a field study, Diabetes Care, 32, 1001, 10.2337/dc08-1722

Ryan, 1990, Mild hypoglycemia associated with deterioration of mental efficiency in children with insulin-dependent diabetes mellitus, J Pediatr, 117, 32, 10.1016/S0022-3476(05)82440-0

Musen, 2008, Impact of diabetes and its treatment on cognitive function among adolescents who participated in the diabetes control and complications trial, Diabetes Care, 31, 1933, 10.2337/dc08-0607

Strudwick, 2005, Cognitive functioning in children with early onset type 1 diabetes and severe hypoglycemia, J Pediatr, 147, 680, 10.1016/j.jpeds.2005.06.010

Ly, 2011, Neurocognitive outcomes in young adults with early-onset type 1 diabetes: a prospective follow-up study, Diabetes Care, 34, 2192, 10.2337/dc11-0697

Hershey, 2005, Frequency and timing of severe hypoglycemia affects spatial memory in children with type 1 diabetes, Diabetes Care, 28, 2372, 10.2337/diacare.28.10.2372

Aye, 2011, The feasibility of detecting neuropsychologic and neuroanatomic effects of type 1 diabetes in young children, Diabetes Care, 34, 1458, 10.2337/dc10-2164

Auer, 1989, Neuropathologic findings in three cases of profound hypoglycemia, Clin Neuropathol, 8, 63

Ho, 2008, Prevalence of structural central nervous system abnormalities in early-onset type 1 diabetes mellitus, J Pediatr, 153, 385, 10.1016/j.jpeds.2008.03.005

Hershey, 2010, Hippocampal volumes in youth with type 1 diabetes, Diabetes, 59, 236, 10.2337/db09-1117

Perantie, 2007, Regional brain volume differences associated with hyperglycemia and severe hypoglycemia in youth with type 1 diabetes, Diabetes Care, 30, 2331, 10.2337/dc07-0351

Mazaika, 2016, Variations in brain volume and growth in young children with type 1 diabetes, Diabetes, 65, 476, 10.2337/db15-1242

Cameron, 2015, The impact of diabetes on brain function in childhood and adolescence, Pediatr Clin N Am, 62, 911, 10.1016/j.pcl.2015.04.003

Schoenle, 2002, Impaired intellectual development in children with type 1 diabetes: association with HbA1c, age at diagnosis and sex, Diabetologia, 45, 108, 10.1007/s125-002-8250-6

Ferguson, 2005, Influence of an early-onset age of type 1 diabetes on cerebral structure and cognitive function, Diabetes Care, 28, 1431, 10.2337/diacare.28.6.1431

Davis, 1996, Acute hyperglycaemia impairs cognitive function in children with IDDM, J Pediatr Endocrinol Metab, 9, 455, 10.1515/JPEM.1996.9.4.455

Perantie, 2008, Effects of prior hypoglycemia and hyperglycemia on cognition in children with type 1 diabetes mellitus, Pediatr Diabetes, 9, 87, 10.1111/j.1399-5448.2007.00274.x

Arbelaez, 2013, Glycemic extremes in youth with T1DM: the structural and functional integrity of the developing brain, Pediatr Diabetes, 14, 541, 10.1111/pedi.12088

Mauras, 2015, Longitudinal assessment of neuroanatomical and cognitive differences in young children with type 1 diabetes: association with hyperglycemia, Diabetes, 64, 1770, 10.2337/db14-1445

Dafoulas, 2017, Type 1 diabetes mellitus and risk of incident epilepsy: a population-based, open-cohort study, Diabetologia, 60, 258, 10.1007/s00125-016-4142-x

Chou, 2016, Risk of epilepsy in type 1 diabetes mellitus: a population-based cohort study, Diabetologia, 59, 1196, 10.1007/s00125-016-3929-0

Trico, 2017, Metabolic brain adaptations to recurrent hypoglycaemia may explain the link between type 1 diabetes mellitus and epilepsy and point towards future study and treatment options, Diabetologia, 60, 938, 10.1007/s00125-017-4231-5

Kiec-Wilk, 2016, Hypoglycemic episodes are associated with inflammatory status in patients with type 1 diabetes mellitus, Atherosclerosis, 251, 334, 10.1016/j.atherosclerosis.2016.05.002

Ratter, 2017, Proinflammatory effects of hypoglycemia in humans with or without diabetes, Diabetes, 66, 1052, 10.2337/db16-1091

Harris, 2013, Descriptions of health states associated with increasing severity and frequency of hypoglycemia: a patient-level perspective, Patient Prefer Adherence, 7, 925, 10.2147/PPA.S46805

Driscoll, 2016, Fear of hypoglycemia in children and adolescents and their parents with type 1 diabetes, Curr Diab Rep, 16, 77, 10.1007/s11892-016-0762-2

Barnard, 2014, Closing the loop overnight at home setting: psychosocial impact for adolescents with type 1 diabetes and their parents, BMJ Open Diabetes Res Care, 2, e000025, 10.1136/bmjdrc-2014-000025

Majidi, 2015, Anxiety in children and adolescents with type 1 diabetes, Curr Diab Rep, 15, 619, 10.1007/s11892-015-0619-0

Martyn-Nemeth, 2016, Fear of hypoglycemia in adults with type 1 diabetes: impact of therapeutic advances and strategies for prevention - a review, J Diabetes Complicat, 30, 167, 10.1016/j.jdiacomp.2015.09.003

Van Name, 2018, Nighttime is the worst time: parental fear of hypoglycemia in young children with type 1 diabetes, Pediatr Diabetes, 19, 114, 10.1111/pedi.12525

Haugstvedt, 2010, Fear of hypoglycaemia in mothers and fathers of children with type 1 diabetes is associated with poor glycaemic control and parental emotional distress: a population-based study, Diabet Med, 27, 72, 10.1111/j.1464-5491.2009.02867.x

Hawkes, 2014, Fear of hypoglycemia in parents of children with type 1 diabetes, J Paediatr Child Health, 50, 639, 10.1111/jpc.12621

Patton, 2007, Parental fear of hypoglycemia: young children treated with continuous subcutaneous insulin infusion, Pediatr Diabetes, 8, 362, 10.1111/j.1399-5448.2007.00242.x

Abraham, 2018, Unexpected management behaviors in adolescents with type 1 diabetes using sensor-augmented pump therapy, J Diabetes Sci Technol, 12, 592, 10.1177/1932296817752188

Cryer, 1999, Symptoms of hypoglycemia, thresholds for their occurrence, and hypoglycemia unawareness, Endocrinol Metab Clin N Am, 28, 495, 10.1016/S0889-8529(05)70084-0

Jones, 1991, Independent effects of youth and poor diabetes control on responses to hypoglycemia in children, Diabetes, 40, 358, 10.2337/diab.40.3.358

Hepburn, 1991, Hypoglycaemia unawareness in type 1 diabetes: a lower plasma glucose is required to stimulate sympatho-adrenal activation, Diabet Med, 8, 934, 10.1111/j.1464-5491.1991.tb01533.x

Jones, 1997, Resistance to neuroglycopenia: an adaptive response during intensive insulin treatment of diabetes, J Clin Endocrinol Metab, 82, 1713

McCrimmon, 1995, Symptoms of hypoglycemia in children with IDDM, Diabetes Care, 18, 858, 10.2337/diacare.18.6.858

Tupola, 1998, Documented symptomatic hypoglycaemia in children and adolescents using multiple daily insulin injection therapy, Diabet Med, 15, 492, 10.1002/(SICI)1096-9136(199806)15:6<492::AID-DIA600>3.0.CO;2-6

Morris, 1997, Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration Diabetes Audit and Research in Tayside Scotland Medicines Monitoring Unit, Lancet, 350, 1505, 10.1016/S0140-6736(97)06234-X

Amiel, 1986, Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes, N Engl J Med, 315, 215, 10.1056/NEJM198607243150402

Graveling, 2010, Impaired awareness of hypoglycaemia: a review, Diabetes Metab, 36, S64, 10.1016/S1262-3636(10)70470-5

Mokan, 1994, Hypoglycemia unawareness in IDDM, Diabetes Care, 17, 1397, 10.2337/diacare.17.12.1397

Arbelaez, 2014, Blunted glucagon but not epinephrine responses to hypoglycemia occurs in youth with less than 1 yr duration of type 1 diabetes mellitus, Pediatr Diabetes, 15, 127, 10.1111/pedi.12070

Barkai, 1998, Prospective assessment of severe hypoglycaemia in diabetic children and adolescents with impaired and normal awareness of hypoglycaemia, Diabetologia, 41, 898, 10.1007/s001250051005

Ly, 2009, Impaired awareness of hypoglycemia in a population-based sample of children and adolescents with type 1 diabetes, Diabetes Care, 32, 1802, 10.2337/dc09-0541

Abraham, 2017, Reduced prevalence of impaired awareness of hypoglycemia in a population-based clinic sample of youth with type 1 diabetes, Pediatr Diabetes, 18, 729, 10.1111/pedi.12460

Korytkowski, 1998, Reduced beta-adrenergic sensitivity in patients with type 1 diabetes and hypoglycemia unawareness, Diabetes Care, 21, 1939, 10.2337/diacare.21.11.1939

Buckingham, 2008, Duration of nocturnal hypoglycemia before seizures, Diabetes Care, 31, 2110, 10.2337/dc08-0863

Gold, 1994, Frequency of severe hypoglycemia in patients with type I diabetes with impaired awareness of hypoglycemia, Diabetes Care, 17, 697, 10.2337/diacare.17.7.697

Amiel, 1987, Defective glucose counterregulation after strict glycemic control of insulin-dependent diabetes mellitus, N Engl J Med, 316, 1376, 10.1056/NEJM198705283162205

Heller, 1991, Reduced neuroendocrine and symptomatic responses to subsequent hypoglycemia after 1 episode of hypoglycemia in nondiabetic humans, Diabetes, 40, 223, 10.2337/diab.40.2.223

Sandoval, 2006, Acute, same-day effects of antecedent exercise on counterregulatory responses to subsequent hypoglycemia in type 1 diabetes mellitus, Am J Physiol Endocrinol Metab, 290, E1331, 10.1152/ajpendo.00283.2005

Jones, 1998, Decreased epinephrine responses to hypoglycemia during sleep, N Engl J Med, 338, 1657, 10.1056/NEJM199806043382303

Amiel, 1991, Effect of antecedent glucose control on cerebral function during hypoglycemia, Diabetes Care, 14, 109, 10.2337/diacare.14.2.109

Amiel, 1993, Physiological responses to hypoglycemia. Counterregulation and cognitive function, Diabetes Care, 16, 48, 10.2337/diacare.16.3.48

McCrimmon, 2017, RD Lawrence lecture 2015 old habits are hard to break: lessons from the study of hypoglycaemia, Diabet Med, 34, 148, 10.1111/dme.13277

Thompson, 1966, Habituation: a model phenomenon for the study of neuronal substrates of behavior, Psychol Rev, 73, 16, 10.1037/h0022681

McNeilly, 2017, High intensity exercise as a dishabituating stimulus restores Counterregulatory responses in recurrently hypoglycemic rodents, Diabetes, 66, 1696, 10.2337/db16-1533

Cranston, 1994, Restoration of hypoglycaemia awareness in patients with long-duration insulin-dependent diabetes, Lancet, 344, 283, 10.1016/S0140-6736(94)91336-6

Leelarathna, 2013, Restoration of self-awareness of hypoglycemia in adults with long-standing type 1 diabetes: hyperinsulinemic-hypoglycemic clamp substudy results from the HypoCOMPaSS trial, Diabetes Care, 36, 4063, 10.2337/dc13-1004

Beers, 2016, Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial, Lancet Diabetes Endocrinol, 4, 893, 10.1016/S2213-8587(16)30193-0

Mohn, 2002, The effect of subclinical hypothyroidism on metabolic control in children and adolescents with type 1 diabetes mellitus, Diabet Med, 19, 70, 10.1046/j.1464-5491.2002.00635.x

Mohn, 2001, Celiac disease in children and adolescents with type I diabetes: importance of hypoglycemia, J Pediatr Gastroenterol Nutr, 32, 37, 10.1097/00005176-200101000-00012

McAulay, 2000, Addison's disease in type 1 diabetes presenting with recurrent hypoglycaemia, Postgrad Med J, 76, 230, 10.1136/pmj.76.894.230

Phornphutkul, 1998, A novel presentation of Addison disease: hypoglycemia unawareness in an adolescent with insulin-dependent diabetes mellitus, J Pediatr, 132, 882, 10.1016/S0022-3476(98)70325-7

Boileau, 2006, Recurrent comas due to secret self-administration of insulin in adolescents with type 1 diabetes, Diabetes Care, 29, 430, 10.2337/diacare.29.02.06.dc05-1845

Robertson, 2014, ISPAD clinical practice consensus guidelines 2014. Exercise in children and adolescents with diabetes, Pediatr Diabetes, 15, 203, 10.1111/pedi.12176

McMahon, 2007, Glucose requirements to maintain euglycemia after moderate-intensity afternoon exercise in adolescents with type 1 diabetes are increased in a biphasic manner, J Clin Endocrinol Metab, 92, 963, 10.1210/jc.2006-2263

Tamborlane, 2007, Triple jeopardy: nocturnal hypoglycemia after exercise in the young with diabetes, J Clin Endocrinol Metab, 92, 815, 10.1210/jc.2007-0016

Tansey, 2006, The effects of aerobic exercise on glucose and counterregulatory hormone concentrations in children with type 1 diabetes, Diabetes Care, 29, 20, 10.2337/diacare.29.01.06.dc05-1192

Riddell, 2017, Exercise management in type 1 diabetes: a consensus statement, Lancet Diabetes Endocrinol, 377, 10.1016/S2213-8587(17)30014-1

Arky, 1966, Alcohol hypoglycemia. V. Alcohol infusion to test gluconeogenesis in starvation, with special reference to obesity, N Engl J Med, 274, 426, 10.1056/NEJM196602242740803

Kolaczynski, 1988, The acute effect of ethanol on counterregulatory response and recovery from insulin-induced hypoglycemia, J Clin Endocrinol Metab, 67, 384, 10.1210/jcem-67-2-384

Turner, 2001, The effect of evening alcohol consumption on next-morning glucose control in type 1 diabetes, Diabetes Care, 24, 1888, 10.2337/diacare.24.11.1888

Schrieks, 2015, The effect of alcohol consumption on insulin sensitivity and glycemic status: a systematic review and meta-analysis of intervention studies, Diabetes Care, 38, 723, 10.2337/dc14-1556

Monaghan, 2009, Nighttime caregiving behaviors among parents of young children with type 1 diabetes: associations with illness characteristics and parent functioning, Fam Syst Health, 27, 28, 10.1037/a0014770

Matyka, 1999, Counterregulation during spontaneous nocturnal hypoglycemia in prepubertal children with type 1 diabetes, Diabetes Care, 22, 1144, 10.2337/diacare.22.7.1144

Beregszaszi, 1997, Nocturnal hypoglycemia in children and adolescents with insulin-dependent diabetes mellitus: prevalence and risk factors, J Pediatr, 131, 27, 10.1016/S0022-3476(97)70121-5

Matyka, 1999, Cognitive function and mood after profound nocturnal hypoglycaemia in prepubertal children with conventional insulin treatment for diabetes, Arch Dis Child, 81, 138, 10.1136/adc.81.2.138

Kaufman, 2002, Nocturnal hypoglycemia detected with the continuous glucose monitoring system in pediatric patients with type 1 diabetes, J Pediatr, 141, 625, 10.1067/mpd.2002.129175

Wilson, 2015, Factors associated with nocturnal hypoglycemia in at-risk adolescents and young adults with type 1 diabetes, Diabetes Technol Ther, 17, 385, 10.1089/dia.2014.0342

Buckingham, 2013, Outpatient safety assessment of an in-home predictive low-glucose suspend system with type 1 diabetes subjects at elevated risk of nocturnal hypoglycemia, Diabetes Technol Ther, 15, 622, 10.1089/dia.2013.0040

Porter, 1997, Incidence and predictive criteria of nocturnal hypoglycemia in young children with insulin-dependent diabetes mellitus, J Pediatr, 130, 366, 10.1016/S0022-3476(97)70197-5

Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, 2010, Prolonged nocturnal hypoglycemia is common during 12 months of continuous glucose monitoring in children and adults with type 1 diabetes, Diabetes Care, 33, 1004, 10.2337/dc09-2081

Clarke, 2008, Assessment and management of hypoglycemia in children and adolescents with diabetes, Pediatr Diabetes, 9, 165, 10.1111/j.1399-5448.2008.00405.x

Mitsuishi, 2015, Can fasting glucose levels or post-breakfast glucose fluctuations predict the occurrence of nocturnal asymptomatic hypoglycemia in type 1 diabetic patients receiving basal-bolus insulin therapy with long-acting insulin?, PLoS One, 10, e0144041, 10.1371/journal.pone.0144041

Kalergis, 2003, Impact of bedtime snack composition on prevention of nocturnal hypoglycemia in adults with type 1 diabetes undergoing intensive insulin management using lispro insulin before meals: a randomized, placebo-controlled, crossover trial, Diabetes Care, 26, 9, 10.2337/diacare.26.1.9

Miles, 2008, Insulin analog preparations and their use in children and adolescents with type 1 diabetes mellitus, Paediatr Drugs, 10, 163, 10.2165/00148581-200810030-00005

Barton, 2010, Is bedtime supper necessary for older children with diabetes using glargine insulin in multiple daily injection regimens?, Diabet Med, 27, 238, 10.1111/j.1464-5491.2009.02900.x

Urakami, 2017, A randomized crossover study of the efficacy and safety of switching from insulin glargine to insulin degludec in children with type 1 diabetes, Endocr J, 64, 133, 10.1507/endocrj.EJ16-0294

Willi, 2003, Benefits of continuous subcutaneous insulin infusion in children with type 1 diabetes, J Pediatr, 143, 796, 10.1067/S0022-3476(03)00579-1

Brodows, 1984, Treatment of insulin reactions in diabetics, JAMA, 252, 3378, 10.1001/jama.1984.03350240024032

Georgakopoulos, 1990, Recovery from insulin-induced hypoglycemia after saccharose or glucose administration, Clin Physiol Biochem, 8, 267

Wiethop, 1993, Alanine and terbutaline in treatment of hypoglycemia in IDDM, Diabetes Care, 16, 1131, 10.2337/diacare.16.8.1131

McTavish, 2011, Effective treatment of hypoglycemia in children with type 1 diabetes: a randomized controlled clinical trial, Pediatr Diabetes, 12, 381, 10.1111/j.1399-5448.2010.00725.x

McTavish, 2018, Weight-based carbohydrate treatment of hypoglycaemia in people with type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial, Diabet Med, 35, 339, 10.1111/dme.13576

Tsalikian, 2006, Prevention of hypoglycemia during exercise in children with type 1 diabetes by suspending basal insulin, Diabetes Care, 29, 2200, 10.2337/dc06-0495

Chung, 2015, Minimizing morbidity of hypoglycemia in diabetes: a review of mini-dose glucagon, J Diabetes Sci Technol, 9, 44, 10.1177/1932296814547518

Pearson, 2008, Glucagon as a treatment of severe hypoglycemia: safe and efficacious but underutilized, Diabetes Educ, 34, 128, 10.1177/0145721707312400

Sherr, 2016, Glucagon nasal powder: a promising alternative to intramuscular glucagon in youth with type 1 diabetes, Diabetes Care, 39, 555, 10.2337/dc15-1606

Rickels, 2016, Intranasal glucagon for treatment of insulin-induced hypoglycemia in adults with type 1 diabetes: a randomized crossover noninferiority study, Diabetes Care, 39, 264, 10.2337/dc15-1498

Yale, 2017, Faster use and fewer failures with needle-free nasal glucagon versus injectable glucagon in severe hypoglycemia rescue: a simulation study, Diabetes Technol Ther, 19, 423, 10.1089/dia.2016.0460

Wood, 2007, Is D50 too much of a good thing? A reappraisal of the safety of 50% dextrose administration in patients with hypoglycemia, JEMS, 32, 103, 10.1016/S0197-2510(07)70090-6

Gunning, 1978, Bioactivity of instant glucose. Failure of absorption through oral mucosa, JAMA, 240, 1611, 10.1001/jama.1978.03290150057025

Graz, 2008, Sublingual sugar for hypoglycaemia in children with severe malaria: a pilot clinical study, Malar J, 7, 242, 10.1186/1475-2875-7-242

Health Organization, 2003, Guidelines for the Inpatient Treatment of Severely Malnourished Children

Haymond, 2001, Mini-dose glucagon rescue for hypoglycemia in children with type 1 diabetes, Diabetes Care, 24, 643, 10.2337/diacare.24.4.643

Battelino, 2011, Effect of continuous glucose monitoring on hypoglycemia in type 1 diabetes, Diabetes Care, 34, 795, 10.2337/dc10-1989

Battelino, 2012, The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial, Diabetologia, 55, 3155, 10.1007/s00125-012-2708-9

Bergenstal, 2010, Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes, N Eng J Med, 363, 311, 10.1056/NEJMoa1002853

Choudhary, 2013, Real-time continuous glucose monitoring significantly reduces severe hypoglycemia in hypoglycemia-unaware patients with type 1 diabetes, Diabetes Care, 36, 4160, 10.2337/dc13-0939

Ly, 2012, Hypoglycemia does not change the threshold for arousal from sleep in adolescents with type 1 diabetes, Diabetes Technol Ther, 14, 101, 10.1089/dia.2011.0144

Buckingham, 2005, Response to nocturnal alarms using a real-time glucose sensor, Diabetes Technol Ther, 7, 440, 10.1089/dia.2005.7.440

Tamborlane, 2008, Continuous glucose monitoring and intensive treatment of type 1 diabetes, N Engl J Med, 359, 1464, 10.1056/NEJMoa0805017

Choudhary, 2011, Insulin pump therapy with automated insulin suspension in response to hypoglycemia: reduction in nocturnal hypoglycemia in those at greatest risk, Diabetes Care, 34, 2023, 10.2337/dc10-2411

Ly, 2012, Analysis of glucose responses to automated insulin suspension with sensor-augmented pump therapy, Diabetes Care, 35, 1462, 10.2337/dc12-0052

Abraham, 2016, Effectiveness of a predictive algorithm in the prevention of exercise-induced hypoglycemia in type 1 diabetes, Diabetes Technol Ther, 18, 543, 10.1089/dia.2016.0141

Abraham, 2016, Prevention of insulin-induced hypoglycemia in type 1 diabetes with predictive low glucose management system, Diabetes Technol Ther, 18, 436, 10.1089/dia.2015.0364

Danne, 2014, The PILGRIM study: in silico modeling of a predictive low glucose management system and feasibility in youth with type 1 diabetes during exercise, Diabetes Technol Ther, 16, 338, 10.1089/dia.2013.0327

Biester, 2017, "Let the algorithm do the work": reduction of hypoglycemia using sensor-augmented pump therapy with predictive insulin suspension (SmartGuard) in pediatric type 1 diabetes patients, Diabetes Technol Ther, 19, 173, 10.1089/dia.2016.0349

Choudhary, 2016, Hypoglycemia prevention and user acceptance of an insulin pump system with predictive low glucose management, Diabetes Technol Ther, 18, 288, 10.1089/dia.2015.0324

Scaramuzza, 2017, Use of the predictive low glucose management (PLGM) algorithm in Italian adolescents with type 1 diabetes: CareLink data download in a real-world setting, Acta Diabetol, 54, 317, 10.1007/s00592-016-0927-0

Villafuerte Quispe, 2017, Effectiveness of MiniMed 640G with SmartGuard(R) system for prevention of hypoglycemia in pediatric patients with type 1 diabetes mellitus, Endocrinol Diabetes Nutr, 64, 198, 10.1016/j.endinu.2017.02.008

Russell, 2014, Outpatient glycemic control with a bionic pancreas in type 1 diabetes, N Engl J Med, 371, 313, 10.1056/NEJMoa1314474

Russell, 2016, Day and night glycaemic control with a bionic pancreas versus conventional insulin pump therapy in preadolescent children with type 1 diabetes: a randomised crossover trial, Lancet Diabetes Endocrinol, 4, 233, 10.1016/S2213-8587(15)00489-1

Garg, 2017, Glucose outcomes with the in-home use of a hybrid closed-loop insulin delivery system in adolescents and adults with type 1 diabetes, Diabetes Technol Ther, 19, 155, 10.1089/dia.2016.0421

Eugster, 2006, Position statement: continuous subcutaneous insulin infusion in very young children with type 1 diabetes, Pediatrics, 118, e1244, 10.1542/peds.2006-0662

O'Connell, 2008, Optimizing postprandial glycemia in pediatric patients with type 1 diabetes using insulin pump therapy: impact of glycemic index and prandial bolus type, Diabetes Care, 31, 1491, 10.2337/dc08-0306

Smart, 2013, Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive, Diabetes Care, 36, 3897, 10.2337/dc13-1195

Ly, 2011, Improving epinephrine responses in hypoglycemia unawareness with real-time continuous glucose monitoring in adolescents with type 1 diabetes, Diabetes Care, 34, 50, 10.2337/dc10-1042