title: Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000-2009.
abstract: OBJECTIVE
  To examine rates of severe hypoglycemia (SH) in a large population-based cohort of children with type 1 diabetes and relationships to HbA(1c).
  
  
  METHODS
  Data from 1,683 children (mean [SD] age at diagnosis 10.5 [4.2]; range 1-18 years) from 2000 to 2009 were analyzed from the Western Australian Children's Diabetes Database. Rates of SH were related to HbA(1c) using negative binomial regression.
  
  
  RESULTS
  A total of 7,378 patient-years of data and 780 SH events were recorded. The rate of SH per 100 patient-years peaked at 17.3 in 2001 and then declined from 2004 to a nadir of 5.8 in 2006. HbA(1c) <7% was not associated with higher risk of SH (incidence rate ratio 1.2 [95% CI 0.9-1.6], P = 0.29) compared with HbA(1c) of 8-9%.
  
  
  CONCLUSIONS
  In a sample of youth with type 1 diabetes, there has been a decrease in rates of SH and a weaker relationship with glycemic control than previously observed.
authors.affiliation: Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia. tim.jones@health.wa.gov.au
authors.forename: Susan M
authors.initials: SM
authors.lastname: O'Connell
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Cooper
authors.forename: Max K
authors.initials: MK
authors.lastname: Bulsara
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davis
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006776:Hospitals, Pediatric; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D015994:Incidence; D007223:Infant; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D015233:Models, Statistical; D011159:Population Surveillance; D012306:Risk
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin