title: The relationship between nonroutine use of insulin, food, and exercise and the occurrence of hypoglycemia in adults with IDDM and varying degrees of hypoglycemic awareness and metabolic control.
abstract: The purpose of this study was to determine objectively the relationships between changes in the usual amount of insulin injected, food eaten, and exercise performed, and the subsequent occurrence of low blood glucose (< 3.9 mM) in adults with IDDM and varying degrees of hypoglycemic awareness and metabolic control. Subjects used a handheld computer to record whether their most recent insulin, food, and exercise had been omitted or were greater than, less than, or about the same as usual following every measured blood glucose level of < 3.9 mM and > 5.6 mM. Responses for each self-management behavior were compared for the two blood glucose ranges. Food was omitted more frequently prior to a low glucose reading and exercise was omitted more frequently prior to a high glucose reading. More insulin, less food, and more exercise each were associated with low glucose levels. These findings underscore the importance of traditional diabetes education.
authors.affiliation: Department of Pediatrics, and Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville (Drs Clarke, Cox, and Gonder-Frederick and Ms Julian)
authors.forename: W L
authors.initials: WL
authors.lastname: Clarke
authors.affiliation: Department of Pediatrics, and Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville (Drs Clarke, Cox, and Gonder-Frederick and Ms Julian)
authors.forename: D J
authors.initials: DJ
authors.lastname: Cox
authors.affiliation: Department of Pediatrics, and Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville (Drs Clarke, Cox, and Gonder-Frederick and Ms Julian)
authors.forename: L A
authors.initials: LA
authors.lastname: Gonder-Frederick
authors.affiliation: Department of Pediatrics, and Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville (Drs Clarke, Cox, and Gonder-Frederick and Ms Julian)
authors.forename: D
authors.initials: D
authors.lastname: Julian
authors.affiliation: The Diabetes Re­search and Training Center of Vanderbilt University, Nashville, Tennes­see ( Dr Schlundt)
authors.forename: D
authors.initials: D
authors.lastname: Schlundt
authors.affiliation: The Joslin Diabetes Clinic, Boston, Massachusetts (Dr Polonsky)
authors.forename: W
authors.initials: W
authors.lastname: Polonsky
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000517:prevention & control*; D003927:Diet, Diabetic; D015444:Exercise; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008499:Medical Records; D008838:Microcomputers; D010353:Patient Education as Topic; D011446:Prospective Studies; D012648:Self Care
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin