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Quantifying the risk of hypoglycaemia in children undergoing the glucagon stimulation test

Song Hai Lim1, Rashida Vasanwala, Ngee Lek

  • 1Endocrinology Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.

Clinical Endocrinology
|May 26, 2011
PubMed

Insights

The low-dose glucagon stimulation test (GST) carries a risk of hypoglycemia in children, particularly those under 8 years old. Continuous blood glucose monitoring is recommended for safety during this test.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diagnostic Testing

Background:

  • The low-dose glucagon stimulation test (GST) is commonly used to assess growth hormone status in children.
  • It is generally assumed that lower doses of glucagon result in fewer episodes of hypoglycemia (low blood glucose).

Purpose of the Study:

  • To quantify the risk of hypoglycemia during the low-dose GST in pediatric patients.
  • To identify specific risk factors, such as age, associated with adverse blood glucose fluctuations during the test.

Main Methods:

  • Retrospective review of blood glucose (BG) fluctuations during GST in 80 children (median age 8.7 years).
  • Patients received a median dose of 20.5 μg/kg of intramuscular glucagon.
  • Rates of hypoglycemia (BG < 3.3 mmol/L), falling BG trends, and combined events were analyzed.

Main Results:

  • Hypoglycemia occurred in 27 out of 80 children during the GST.
  • A falling BG trend was observed in 26 children, who were significantly younger than those with a rising trend (median age 5.1 vs 9.6 years).
  • Forty-four children were identified as at-risk, with children under 8 years old having a 2.63 times higher odds of being at-risk.

Conclusions:

  • Hypoglycemia is a notable risk during the low-dose GST in children.
  • Younger children, particularly those under 8 years old, are at increased risk.
  • Continuous blood glucose monitoring during the GST is essential for patient safety.
Abstract

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