Endocrine Abstracts

Hypoglycaemia continues to be a difficult condition to treat especially in infants and young children who cannot administer treatment themselves. Administering the correct dose of sugar is difficult for several reasons: the child may not want to intake food and it may be difficult to force the child to chew or swallow, it is difficult to identify the quantity of sugar necessary to reach optimal glucose levels. If too much sugar is administered, high levels of blood glucose may result from liver glycogenolysis and, to reduce hyperglycaemia, the patient needs more insulin. However if more insulin is administered the child will need more food. This situation produces a ‘vicious circle’ and an alternative therapy is needed.

The aim of the study was to evaluate the effect of administering small amounts of glucose through the glucose RapidSpray™ (GRS) during hypoglycaemia to prevent hyperglycaemic rebound in children with type 1 diabetes (T1D) and to study the efficacy of RGS so as to improve the metabolic control.

We designed an open randomized trial in children with T1D aged 1–5 years.

Forty-eight patients with T1D, age-group 1–5 years, were randomly allocated into 2 groups: (A) RGS in the treatment of early warning signs of hypoglycaemia (10–20 puffs of RGS, 0.5–1 g glucose) during episodes of early symptoms of hypoglycaemia; (B) traditional treatment of hypoglycaemia episodes.

Parameters of efficacy were: (1) HbA1c at time 0, at 3 months follow-up and at the end of the study, (2) features of hypoglycaemia episodes, (3) quality of life.

At present 17 patients have been introduced in the study. No adverse effects were observed and treatment with RGS was easily accepted by children and mothers. Quality of life under the unpleasant circumstances of hypoglycaemia can be improved by the use of RGS.