INTRODUCTION Recommended hypoglycemia treatment in adults considers 15 grams of carbohydrates. Suspension technology might warrant lower needs. Our aim was evaluating the response to fewer carbohydrates for treating hypoglycemia in T1D patients on CSII with PLGS. METHOD: Participants were blindly randomized to receive 15 or 10 grams of sucrose per episode. Treatment was indicated when capillary glycemia (CG) was <65 mg/dL, and duplicated if it was <50 mg/dL. Fifteen minutes after treatment, if CG was <65 mg/dL re-treatment was indicated, and if it was >65 mg/dL, infusion was manually resumed. After 2 weeks, participants did crossover to the other treatment. Sensor glucose, active insulin and time in suspension were also assessed. RESULTS: Sixteen subjects participated. 70 episodes were recorded with 11 excluded for protocol violation. 85% episodes occurred with active insulin. Baseline CG, at 15 and 30 minutes was 57, 95 and 111 mg/dL for 26 episodes with 15 grams and 54, 77 and 112 mg/dL for 33 episodes on 10 grams (p=0.168, p=0.0007 and p=0.899, respectively). At baseline, 20% of episodes were <50 mg/dL and required duplicated doses, and active insulin was 1.3 units for 15 grams and 1.7 for 10 grams (p=0.414). None of the 15 grams episodes required re-treatment, compared with 21% of the 10 grams episodes. No severe hypoglycecmia and no rebound hyperglycemia occurred. CONCLUSIONS: In T1D patients on CSII with PLGS, a hypoglycemia treatment protocol with 10 grams of sucrose is effective but could require repetition of treatment. Manual resuming after treatment might warrant no risk of hyperglycemia with standard doses.
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