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Not much strikes fear into the hearts of the parents of a type 1 child than one who is sick and cannot hold his or her food down or who refuses to eat. But researchers at Baylor College of Medicine in Houston, Texas, have found a solution.
Writing in the April issue of Diabetes Care, the researchers suggest giving these children small doses of glucagon to help maintain blood-glucose level. Glucagon, available by prescription, causes the body to release glucose into the bloodstream.
Using a standard U-100 insulin syringe, children with mild or impending hypoglycemia were given small doses of reconstituted glucagon. Dosages were adjusted for age, with children under two years of age getting two units of glucagon. Children over the age of two received one unit of glucagon for each year of age, up to a maximum of 15 units. If the child's blood-glucose levels did not increase in 30 minutes, a second injection, containing twice as much glucagon as the first injection, was given.
Thirty-three cases were analyzed and 14 children required a second dose of glucagon while they were sick. Only four children required a third dose. While hospitalization was required in five cases, it was because doctors had concerns about fever and dehydration, not about hypoglycemia. In the other 28 cases, the children fully recovered and were able to remain at home.
Researchers say giving glucagon in small doses raised blood-glucose levels while avoiding the nausea and vomiting associated with taking a full dose of glucagon. They caution, however, that the full dose of glucagon should be given in instances of severe hypoglycemia. The average blood-glucose level for the children treated with small doses of glucagon was 62 mg/dl before treatment, rising to an average of 146 mg/dl after treatment.
Since the children in the study were as old as 15 years, researchers say the results could also be applied to adults who are unable to eat because of gastrointestinal problems.
The authors advised parents to keep the reconstituted glucagon in the refrigerator and to discard it after 24 hours.
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