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Correspondence
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Volume 353:2516-2517 December 8, 2005 Number 23
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Secret Insulin-Injection Syndrome among Adolescents with Type 1 Diabetes

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To the Editor: Despite improvements in the management of type 1 diabetes mellitus, severe hypoglycemia is not rare among young patients. The incidence of severe hypoglycemia ranges from 0.02 to 0.07 case per patient–month, including episodic recurrence in approximately 20 percent of patients.1,2,3 Since 1990, we have identified 16 patients (15 girls and 1 boy) who had more than three comas within three months, all of whom admitted, generally years later, that they had secretly self-administered large doses of regular insulin. The mean (±SD) age of the patients was 12.9±0.5 years, the mean duration of diabetes was 6.2±0.7 years, and . . . [Full Text of this Article]



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