Hyperglycemia during childhood diarrhea.
OBJECTIVE
To determine the cause of hyperglycemia in childhood diarrhea.


METHODS
During an 8-month period, patients admitted to a diarrhea treatment center in Bangladesh had their blood glucose concentrations determined. Sixteen patients aged 2 to 10 years with hyperglycemia (blood glucose concentration >10.0 mmol/L) and 20 patients in the same age group with a normal blood glucose concentration (3.3 to 9.0 mmol/L) had blood samples obtained on admission and 4 and 24 hours later for determination of glucoregulatory hormones and gluconeogenic substrates.


RESULTS
Prevalence of hyperglycemia among patients aged 2 to 10 years was 9.4%. Compared with the normoglycemic patients, hyperglycemic patients more often had severe dehydration (100% versus 10%, p <0.001), infection with Vibrio cholerae 0 1 or toxigenic Escherichia coli (94% vs 25%, p <0.001), and had similar duration of fasting (16 vs 14 hours, p = 0.677). Concentrations of epinephrine (7.15 vs 2.00 micromol/L), norepinephrine (10.35 vs 3.50 micromol/L), cortisol (1.38 vs 0.82 micromol/L), glucagon (36 vs 14 pmol/L), and C-peptide (1.22 vs 0.35 nmol/L) were all significantly (p < or = 0.014) higher in patients with hyperglycemia than in normoglycemic patients.


CONCLUSIONS
The development of hyperglycemia in diarrhea is caused by a stress response to hypovolemia.
Ronan
A
A
Royal Children's Hospital, Melbourne, Victoria, Australia.
Azad
A K
AK
Rahman
O
O
Phillips
R E
RE
Bennish
M L
ML
D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000150:complications; D003681:Dehydration / Q000150:complications; D003967:Diarrhea / Q000097:blood / Q000150:complications* / Q000382:microbiology; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D008297:Male; D009638:Norepinephrine / Q000097:blood
D001786:Blood Glucose; D005934:Glucagon; D009638:Norepinephrine