Transient hyperglycemia in acute childhood illnesses: to attend or ignore?
Transient hyperglycemia occurs as a part of stress response in acute illnesses and is brought about by elevated levels of counter regulatory hormones. It is frequently encountered but the exact prevalence and implications, especially in childhood have not been studied in detail, 758 children (1 month to 6 years) with acute illness were screened for hyperglycemia; of these 36 children were found to have a glucose level of > or = 150 mg/dl at admission and were designated hyperglycemics. The overall prevalence of hyperglycemia was 4.7 per cent. The disease-wise prevalence in neurological disorders, septicemia, respiratory illnesses and diarrhoea was 7.9, 7.6, 4.2 and 3.0 per cent respectively. Family history of diabetes did not predispose towards developing transient hyperglycemia. The demographic profile (age, sex, nutrition status and disease pattern) and severity of illness (as assessed by temperature, heart rate, respiratory rate, duration of illness and hospitalization, treatment modalities required, hypoxia and acidosis) did not affect the prevalence, extent and the rate of normalization of hyperglycemia. The mortality in hyperglycemics was double (13.9%) as compared to 6.9% in non-hyperglycemics, although the difference was insignificant, statistically (O.R = 2.17, CI = 0.81-5.82, p > 0.05). It was, therefore, concluded that transient hyperglycemia occurs in 4-5% of patients with acute pediatric illnesses. However, it does not significantly correlate with the clinical profile and severity of the illness, and has no immediate prognostic significance.
Gupta
P
P
Department of Pediatrics, UCMS and GTB Hospital, Delhi, India.
Natarajan
G
G
Agarwal
K N
KN
D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies