Acute effects of hyperglycaemia in children with type 1 diabetes mellitus: the patient's perspective.
BACKGROUND
This study presents the results of a systematic examination of how parents and patients perceive the effects of acute hyperglycaemia on mood and on intellectual and fine-motor performance.


METHODS
A random sample of parents and children with type 1 diabetes mellitus (n = 380) were asked via questionnaire about their perception of the effects of hyperglycaemia.


RESULTS
Answers were received from 368 children and parents (97%); mean age was 12.5 years (range 3.7 to 19.8 years). Blood glucose levels between 15-18 mmol/l were reported by 68% to affect thinking performance, by 75% to affect mood and emotions and by 53% to affect coordination. The symptoms most commonly associated with hyperglycaemia were (in decreasing order): irritable (64%), short-tempered (60%), moody (56%), unreasonable (43%), aggressive (37%), hyperactive (31%), sad/depressed (27%) confused (23%), clumsy (18%). Homework was thought to be affected by hyperglycaemia in 36%, sport in 25%, play activity in 32%. Higher mean HbA1c since diagnosis was associated with higher reporting of effects on feeling/mood (p <0.001). Parents were especially concerned about the effects of hyperglycaemia on school and social interaction.


CONCLUSIONS
The effects of hyperglycaemia on immediate performance are of concern to children and parents. Hyperglycaemia (15-18 mmol/l) is reported to influence emotion and behaviour more than intellectual and fine-motor performance. This may contribute to the adverse psychological consequences of type 1 diabetes mellitus in children.
Martin
David D
DD
Princess Margaret Hospital for Children, Perth, Western Australia.
Davis
Elizabeth A
EA
Jones
Timothy W
TW
D000293:Adolescent; D000328:Adult; D000339:Affect; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000031:analogs & derivatives / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D007360:Intelligence; D008297:Male; D009048:Motor Skills; D011597:Psychomotor Performance
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C025617:glucosylated hemoglobin A