Response to Hypo- and Hyperglycemia in Adolescents With Type I Diabetes

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Response to Hypo- and Hyperglycemia in Adolescents With Type I Diabetes
Suzanne Bennett Johnson, PhD, Amy R. Perwien, BA and Janet H. Silverstein, MD
University of Florida Health Sciences Center

All correspondence should be sent to Suzanne Bennett Johnson, Center for Pediatric Psychology and Family Studies, University of Florida Health Science Center, P.O. Box 100165, Gainesville, Florida 32610-0165. E-mail: sjohnson@hp.ufl.edu .

Objective: To assess the appropriateness of adolescents' responses to hypo- and hyperglycemia and to examine the relationship of patient age, gender, diabetes duration, diabetes knowledge, parental supervision, and glycemic control to response appropriateness.

Methods: We assessed 125 adolescents' responses to daily episodes of hypo- and hyperglycemia by 24-hour recall interviews; responses were coded for type and appropriateness.

Results: Adolescents responded inappropriately to 38% of hypoglycemic and 29% of hyperglycemic episodes. Parental supervision of blood glucose testing did not increase the likelihood of an appropriate response; in the case of hyperglycemic episodes, it appeared to be counterproductive. Adolescents who responded inappropriately to hyperglycemia were also older but not different from those who responded appropriately by gender, disease duration, diabetes knowledge, or glycemic control.

Conclusions: Health providers and family members may underestimate adolescents' difficulty managing hypo- and hyperglycemia appropriately. The presence of parental supervision does not ensure an appropriate response; parents may be particularly misinformed about the management of hyperglycemia.

Key words: Type I diabetes; hypoglycemia; hyperglycemia; adolescents; parental supervision.