Hypoglycemia Thresholds in Type 1 Diabetes

Impact of Two Different Hypoglycemia Thresholds on Rebound Hyperglycemia in Children With Type 1 Diabetes: A Crossover Clinical Trial

The aim of this study is to compare the impact of hypoglycaemia treatment initiated at a blood glucose threshold of 65 mg/dL versus the internationally recommended threshold of 70 mg/dL on 2-hour post-treatment blood glucose levels and the subsequent development of rebound hyperglycaemia in children with type 1 diabetes. The main questions it aims to answer are:

Is there a statistically significant difference in 2-hour post-treatment blood glucose levels in children with type 1 diabetes when hypoglycaemia intervention is initiated at a threshold of 70 mg/dL compared to 65 mg/dL?"

In children with type 1 diabetes, does the standard hypoglycaemia treatment initiated at the internationally recommended threshold of 70 mg/dL lead to the development of rebound hyperglycaemia (<180 mg/dL) at the 2nd hour post-treatment?

Patients underwent two protocols: intervention at a 65 mg/dl threshold (hospital routine; experimental group) and 70 mg/dl (literature standard; control group). Both protocols utilised 0.3 g/kg of simple carbohydrates, supplemented with a standardised complex carbohydrate (12.8 g) once blood glucose exceeded the target.

Inclusion Criteria:

• A confirmed diagnosis of type 1 diabetes.
• Absence of any concurrent chronic illnesses.
• Absence of any physiological conditions precluding oral intake.
• Absence of significant cognitive or developmental disorders that would impede capacity to participate in the study.
• Aged between 7 and 18 years (as children under 7 years of age may experience difficulty consuming whole grain crackers).
• Possession of a personal blood glucose monitor.
• Absence of persistent hyperglycaemia.

Exclusion Criteria:

• Days characterised by unusually high levels of routine exercise or physical activity.
• The requirement for a second dose of simple carbohydrates (sugar cubes) during a single hypoglycaemia intervention (as consuming two doses may induce hyperglycaemia following the snack).
• Experiencing multiple hypoglycaemic episodes within the same day.