The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes.
OBJECTIVE
There is a lack of evidence regarding the most effective treatment option for managing naturally occurring hypoglycemia in children with type 1 diabetes. The objectives of this study were (i) to determine if sucrose and fructose are equally effective as glucose in the treatment of spontaneous hypoglycemia in children with type 1 diabetes; and (ii) to determine prestudy and poststudy hypoglycemia treatment preferences.


METHODS
Thirty-three subjects [aged 5.4-15.5 yr and average duration of type 1 diabetes of 3.1 yr (SD = 2.3)] participated in a randomized, crossover design. The main outcome was the effectiveness of treatment as defined by a blood glucose meter reading that was > or = 4.0 mmol/L 15 min after treatment. Each subject treated five hypoglycemic events with each treatment type: glucose (BD Glucose Tablets), sucrose (Skittles), and fructose (Fruit to Go).


RESULTS
There was a significant difference between the effectiveness of the three treatments [Wilk's Lambda F(2,28) = 8.64, p = 0.001]. No significant difference between treatment with glucose and treatment with sucrose was noted, but the treatment effectiveness for fructose was significantly lower than sucrose [F (1,29) = 16.09, p < 0.001] and glucose [F (1,29) = 15.64, p < 0.001]. The preferred treatment choices before the study were as follows: 36% glucose, 18% sucrose, and 33% fructose sources. Poststudy, 52% of children preferred the same treatment, which was effective (glucose or sucrose), followed by 35% who changed their preference to an effective treatment.


CONCLUSIONS
Skittles are as effective in treating hypoglycemia as more expensive BD Glucose Tablets in children with type 1 diabetes.
Husband
Allison C
AC
Diabetes Clinic, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada. allison.husband@albertahealthservices.ca
Crawford
Susan
S
McCoy
Lesley A
LA
Pacaud
Danièle
D
D000293:Adolescent; D002182:Candy; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D004304:Dosage Forms; D005260:Female; D005632:Fructose / Q000627:therapeutic use*; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D013395:Sucrose / Q000627:therapeutic use*; D013810:Therapeutic Equivalency; D016896:Treatment Outcome
D004304:Dosage Forms; D005632:Fructose; D013395:Sucrose; D005947:Glucose