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Transient hyperglycemia in acute childhood illnesses: to attend or ignore?
P Gupta1, G Natarajan, K N Agarwal
1Department of Pediatrics, UCMS and GTB Hospital, Delhi, India.
Insights
Transient hyperglycemia affects nearly 5% of children with acute illnesses. This stress-related condition in pediatric patients does not correlate with illness severity or immediate prognosis.
Area of Science:
- Pediatric Endocrinology
- Critical Care Medicine
- Metabolic Disorders
Background:
- Transient hyperglycemia is a common stress response in acute illnesses, driven by counter-regulatory hormones.
- Its prevalence and implications in pediatric populations remain understudied.
- Understanding this phenomenon is crucial for managing critically ill children.
Purpose of the Study:
- To determine the prevalence of transient hyperglycemia in acutely ill children.
- To investigate the correlation between hyperglycemia and clinical factors, illness severity, and outcomes.
- To assess the prognostic significance of transient hyperglycemia in this demographic.
Main Methods:
- Screening of 758 children (1 month to 6 years) admitted with acute illness for hyperglycemia (glucose ≥ 150 mg/dl).
- Analysis of disease-specific prevalence, demographic data, and illness severity markers.
- Comparison of mortality rates between hyperglycemic and non-hyperglycemic groups.
Main Results:
- Overall prevalence of transient hyperglycemia was 4.7% in the study cohort.
- Higher prevalence observed in neurological disorders (7.9%) and septicemia (7.6%).
- No significant correlation found between hyperglycemia and demographic profile, illness severity, or mortality (O.R. = 2.17, p > 0.05).
Conclusions:
- Transient hyperglycemia occurs in approximately 4-5% of children with acute illnesses.
- It does not appear to be significantly associated with clinical presentation, illness severity, or immediate prognostic value.
- Further research may clarify long-term implications, if any.
Abstract:
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.