الفهرس 
TYPE 1 DIABETESOnly 14 pages are availabe for public view
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Abstract
Abstract:
Background: In general, hypoglycemia is more frequent among young, explaining the higher frequency of impaired awareness of hypoglycemia (IAH) among children and adolescents. Thus the aim of the current study was to assess the frequency of IAH among an Egyptian cohort of children and adolescents with type 1 diabetes and identify the possible role of autonomic neuropathy. Patients and Methods: A cross-sectional study recruiting 100 patients with type 1 diabetes aged less than 18 years old recruited from the Pediatric and Adolescent Diabetes Unit (PADU). The Gold and Clarke questionnaires were used to assess hypoglycemia awareness among the studied cohort. Cardiac autonomic neuropathy (CAN) was assessed using 15 minutes Holter electrocardiography (ECG). Results: Among the studied cohort, 42% showed IAH using the Clarke’s and Gold’s Questionnaire. When assessing CAN, 46% of the studied cohort showed resting tachycardia and patients with resting tachycardia showed significantly longer disease duration. We used sex and age matched control group to find specific cutoff values for heart rate variability parameters to diagnose CAN. The results showed that the prevalence of CAN among studied patients was 88% and there were no significant correlation between CAN and questionnaires score. 55.7% of CAN patients were aware while 44.3% were unaware. Thus, there were no association between impaired awareness of hypoglycemia with CAN. The results showed that there was significant positive correlation between cardiac autonomic neuropathy (CAN) with diabetic duration more than 5 years. Conclusion: Both CAN and IAH are interrelated; due to this complex interaction, it is important to screen for CAN in patients with IAH, especially that CAN is usually asymptomatic among children with type 1 diabetes.