Non-Diabetic Hyperglycemia in the Pediatric Age: Why, How, and When to Treat?
Valentina Fattorusso1, Rosa Nugnes1, Alberto Casertano1
1Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy.
Insights
Non-diabetic hyperglycemia (NDHY) is a poorly understood condition. This review explores management strategies for transient hyperglycemia in non-diabetic individuals, especially children, often linked to stress or medications.
Area of Science:
- Endocrinology
- Pediatrics
- Metabolic Disorders
Background:
- Non-diabetic hyperglycemia (NDHY) is an under-recognized condition.
- Transient hyperglycemia in children, termed stress hyperglycemia (SHY), is not well understood.
- SHY can be categorized into SHY1 (severe illness) and SHY2 (non-life-threatening illness).
Purpose of the Study:
- To review and examine management approaches for non-diabetic hyperglycemia.
- To elucidate the biological effects of transient NDHY, particularly in pediatric populations.
- To identify causes of drug-induced NDHY in children.
Main Methods:
- Literature review of existing studies on NDHY.
- Clinical practice analysis to classify SHY.
- Identification of drug-induced hyperglycemia in pediatric patients.
Main Results:
- NDHY is often transient and resolves after acute illness or stress.
- Pediatric NDHY can be induced by steroid or antineoplastic/immunosuppressive therapies.
- SHY occurs during acute illness, with distinct classifications based on severity.
Conclusions:
- Further research is needed to understand the biological effects of NDHY.
- Effective management strategies for NDHY require further investigation.
- Recognizing NDHY triggers, including medications, is crucial for pediatric care.
Purpose Of Review:
Non-diabetic hyperglycemia (NDHY) is a pathological condition that is not yet well known. The aim of this review is to examine approaches for management of this condition.
Recent Findings:
While it is well known that persistent hyperglycemia in diabetes affects immune response and risk for diabetes-related micro- and macrovascular complications, little is known about the biological effects of transient NDHY, particularly in the pediatric age group. Stress HY (SHY) is typically defined as blood glucose > 8.33 mmol/L (150 mg/dL) during physical stress, resolving spontaneously after dissipation of acute illness in patients without known diabetes. Based on the literature and clinical practice, two situations can be classified: (1) SHY1, which occurs during severe and prolonged illness and under serious life-threatening conditions, mainly in emergency situations and in resuscitation areas; and (2) SHY2, which occurs during acute illness, mainly in non-life-threatening conditions. Furthermore, (NDHY) among pediatric patients can be induced by drugs; the most frequent conditions are secondary to (1) steroid therapy and (2) antineoplastic/immunosuppressive therapy.
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