Hypoglycemia in Children and Adolescents with Type 1 Diabetes in the Pediatric Department of Abass Hospital Ndao (Dakar)

Hypoglycemia in diabetics is defined by the ADA as a blood glucose level below 3.9 mmol /L (Methodology: Abass Hospital Ndao over 3 months (from March 2023 to May 2023). All patients who had hypoglycemia in the 30 days preceding data collection and who met our inclusion criteria were selected. Results: Our study included 38 cases, representing a prevalence of 34% compared to diabetology consultations and a prevalence of severe hypoglycemia of 18%. The mean age of our patients was 13 years. The sex ratio was 1.2. There was no significant link between sex and the number of hypoglycemias. The duration of diabetes was less than 5 years in the majority of cases and was positively correlated with hypoglycemic episodes. The socioeconomic level of the patients was low in the majority of cases. Human or regular insulin was used in 82%. The 3-injection regimen was used in 92% of cases. The mean insulin dose was 0.77 IU/kg/d [0.08 - 1.3 IU/kg/d]. A significant link between the number of hypoglycemic episodes and the type of insulin as well as the insulin doses was not established. However, human insulin was associated with a higher risk of hypoglycemia. Football was the most practiced sport (52% of cases). In our study, 21% of patients had a target glycated hemoglobin level (less than or equal to 7.5%) and 15.8% a level greater than 13%. There was no significant link between hypoglycemic episodes and the drop in glycated hemoglobin between 2 trimesters. The circumstances of occurrence were sport and delayed meal intake each in 25% of patients. We noted insufficient meal intake in 30% of patients, insulin overdose in 10% of cases and an injection without meal intake in 4% of cases. Conclusion: Hypoglycemia is common in children and adolescents with type 1 diabetes on insulin therapy. Severe forms are uncommon. Young age is correlated with a higher risk of hypoglycemia. Despite high hemoglobin levels, the risk of hypoglycemia remains.