title: Effective treatment of hypoglycemia in children with type 1 diabetes: a randomized controlled clinical trial.
abstract: OBJECTIVE
  To determine the most effective of four oral treatments for hypoglycemia in children with type 1 diabetes using a weight-based protocol during diabetes camp.
  
  
  METHODS
  During diabetes camp treatment of hypoglycemia was randomized to one of the four treatments, randomly assigned for each episode using a sealed envelope: glucose tablets, jellybeans, orange juice, and sugar mints (Mentos dragees®). An equivalent carbohydrate dose was calculated for each patient for each treatment (0.3 g carbohydrate/kg) and provided to camp leaders. Glucose was measured at 0, 2, 5, 10, and 15 min and symptoms recorded.
  
  
  RESULTS
  A total of 191 episodes of hypoglycemia were recorded in 39 children (1-12 episodes per child), with 2 episodes excluded because of protocol violations. Fifty-two episodes were treated with glucose tablets, 45 with jellybeans, 44 with juice, and 48 with sugar mints. Change in glucose at 10 (p = 0.034) and 15 min (p = 0.005) and glucose at 15 min (p = 0.026) were significantly different between treatment groups - jellybeans produced the lowest and slowest response. Glucose tablets did not differ significantly from juice or Mentos dragees. There was a trend for repeat treatment to be required more often with a single treatment 'dose' of jellybeans (p = 0.058). Symptoms occurred in 112 episodes, with a median time to symptom resolution of 12 min (interquartile range (IQR) 8-15 min).
  
  
  CONCLUSIONS
  Jellybeans are less effective treatment for hypoglycemia than the other three treatments. Glucose tablets, Mentos dragees® and orange juice are of similar efficacy. Treatment with 0.3 g/kg of carbohydrate (excluding jellybeans) effectively resolved hypoglycemia in most children, with 15 min often required to normalize blood glucose.
authors: Department of Diabetes and Endocrinology, Capital and Coast District Health Board, Wellington, New Zealand.
authors: Lindsay
authors: L
authors: McTavish
authors: Esko
authors: E
authors: Wiltshire
mesh_terms: D001628:Beverages; D001786:Blood Glucose / Q000378:metabolism*; D002182:Candy; D002648:Child; D002957:Citrus; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy*; D008297:Male; D009844:Oligosaccharides / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D009844:Oligosaccharides; D005947:Glucose