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Hypoglycaemia in under-five children with diarrhoea.
S Huq1, M I Hossain, M A Malek
1Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR), GPO Box 128, Dhaka 1000, Bangladesh.
Journal of Tropical Pediatrics
|March 28, 2007
Summary
Hypoglycemia in children with diarrhea is linked to shorter illness duration, seizures, and higher fatality. Bacteraemia significantly increases hypoglycemia risk, suggesting bedside glucose testing aids in managing sepsis in resource-limited settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Medicine
Background:
- Diarrheal illnesses are a major cause of hospitalization in children under five.
- Hypoglycemia is a serious complication of diarrheal diseases, particularly in resource-limited settings.
- Identifying predictors of hypoglycemia is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To investigate the clinical features of hypoglycemia in hospitalized children under five with diarrhea.
- To identify predictors of hypoglycemia in this vulnerable population.
- To inform clinical management and policy decisions for diarrheal disease care.
Main Methods:
- Prospective study of 782 children under five with diarrheal illnesses.
- Blood glucose levels measured when hypoglycemia was suspected.
- Comparison between hypoglycemic (n=65) and non-hypoglycemic (n=195) groups.
- Analysis of clinical features, including duration of diarrhea, convulsions, hospitalization, and mortality.
- Logistic regression to identify independent predictors of hypoglycemia, including bacteraemia.
Main Results:
- Hypoglycemia was identified in 11% of children tested.
- Shorter pre-admission diarrhea duration (<72h), documented convulsions, shorter hospitalization (<72h), and higher case fatality rate were associated with hypoglycemia.
- Bacteraemia was significantly more frequent in children who underwent rapid glucose testing.
- Children with bacteraemia (clinical sepsis) were four times more likely to develop hypoglycemia (OR=4.2).
Conclusions:
- Hypoglycemia is a significant clinical feature in under-five children with diarrhea.
- Bacteraemia is a strong predictor of hypoglycemia in diarrheal illness.
- Rapid bedside glucose testing can aid in diagnosing bacteraemia and guiding antibiotic treatment decisions in resource-limited healthcare settings.
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