title: Pathophysiology of critical illness hyperglycemia in children.
abstract: Causes of hyperglycemia in critically ill non-diabetic children may differ from those in adults. The objective of this study was to investigate the pathogenesis of critical illness hyperglycemia (CIH) in terms of insulin resistance and β-cell dysfunction. Critically ill children with blood glucose (BG) levels of >150 mg/dL (8.3 mmol/L) were enrolled in the study. Insulin sensitivity and β-cell function in the hyperglycemic and euglycemic periods were analyzed with BG/insulin and BG/C-peptide ratios, and utilizing homeostasis model assessment (HOMA). A total of 40 patients were enrolled in the study. BG/insulin and BG/C-peptide ratios were significantly higher in the hyperglycemic period. The HOMA-B and S scores for the hyperglycemic period revealed that out of all the patients who survived (n=30), 20 had β-cell dysfunction, while the remaining (n=11) had insulin resistance. β-cell dysfunction was significantly higher in the hyperglycemic period (p<0.001). As in adults, β-cell dysfunction may play a major role in the pathophysiology of CIH in children.
authors: Bülent
authors: B
authors: Hacıhamdioğlu
authors: Tanıl
authors: T
authors: Kendirli
authors: Gönül
authors: G
authors: Oçal
authors: Zeynep
authors: Z
authors: Sıklar
authors: Senay
authors: S
authors: Savaş Erdeve
authors: Erdal
authors: E
authors: Ince
authors: Merih
authors: M
authors: Berberoğlu
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D007223:Infant; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology; D008297:Male
chemical_list: D001786:Blood Glucose; D002096:C-Peptide