Hypoglycaemia in Clinical Diabetes

32 SYMPTOMS OF HYPOGLYCAEMIAduring the period of hypoglycaemia. Therefore, they would be especially aware of cognitiveshortcomings, making this group of symptoms more prominent and coherent.Symptoms in Children and Older PeopleChildren often have difficulty in recognising symptoms of hypoglycaemia, and they showmarked variability in symptoms between episodes of hypoglycaemia (Macfarlane and Smith,1988). Trembling and sweating are often the first symptoms recognised by children. Frominterviews with the parents of children (aged up to 16 years) with type 1 diabetes, andwith some of their children, more is known about the frequency of symptoms of hypoglycaemiain children (McCrimmon et al., 1995; Ross et al., 1998) (Table 2.4). The mostfrequently reported sign that parents observed was pallor (noted by 88%). The parentsTable 2.4 Symptoms of hypoglycaemia in children (derived from Ross et al., 1998)Frequency of rating (%)Symptom Parents’ reports Children’s reportsCorrelation betweenparents’ and children’sintensity ratings aTearful 73 47 040 dHeadache 73 65 033 dIrritable 85 65 016Uncoordinated 62 56 018Naughty 47 31 023 bWeak 79 83 021 bAggressive 75 62 026 cTrembling 79 88 025 bSleepiness 63 69 027 cNightmares 33 19 033 dSweating 76 73 028 cSlurred speech 53 45 028 cBlurred vision 52 55 030 cTummy pain 67 41 036 dFeeling sick 63 53 032 cHungry 74 84 019Yawning 48 45 020 bOdd behaviour 65 50 022 bWarmness 57 68 013Restless 61 57 021 bDaydreaming 70 48 014Argumentative 64 50 021 bPounding heart 21 44 002Confused 75 70 041 dTingling lips 20 24 −001Dizziness 66 87 028 cTired 83 76 026 cFeeling awful 92 79 020a Correlations: p of z (corrected for ties) 1.0 represents perfect agreement; 0 represents no agreement.b p