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Frequency of hypoglycemia in children with adrenal insufficiency
Insights
Hypoglycemia affects 18% of children with primary adrenal insufficiency, particularly in newborns. Lower cortisol levels correlate with hypoglycemia in these patients.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
Background:
- Primary adrenal insufficiency, including Congenital Adrenal Hyperplasia and Addison's Disease, affects children.
- Hypoglycemia is a known complication of adrenal insufficiency.
Purpose of the Study:
- To determine the frequency of hypoglycemia in children with primary adrenal insufficiency.
- To explore the relationship between hypoglycemia and cortisol levels in this population.
Main Methods:
- Retrospective analysis of 165 children with primary adrenal insufficiency.
- Evaluation of hypoglycemia occurrence, timing, and association with cortisol levels.
Main Results:
- 18% of children experienced hypoglycemia, with half occurring in the neonatal period.
- Significantly lower basal plasma cortisol levels were observed in children with hypoglycemia.
- A strong correlation was found between plasma glucose and cortisol concentrations during hypoglycemic episodes.
Conclusions:
- Hypoglycemia is a notable complication in pediatric primary adrenal insufficiency, especially in neonates.
- Low cortisol levels are associated with hypoglycemia, highlighting the importance of monitoring glucose and cortisol in affected children.
Abstract:
The frequency of hypoglycemia in 165 children with primary adrenal insufficiency, 118 of whom had Congenital Adrenal Hyperplasia and 47 Addison's Disease, was 18%. Half of the hypoglycemic episodes occurred in the neonatal period. Hypoglycemia was isolated in 13 children, revealing the disease in 4 newborns with Congenital Adrenal Hypoplasia and in a boy with 11 B Hydroxylase deficiency. Basal plasma cortisol levels were significantly lower in those of subjects who experienced hypoglycemia (47.1 +/- 28.6 ng/ml vs. 106.0 +/- 86.6 ng/ml, p less than 0.001). A significant correlation (p less than 0.001) was found between the plasma concentration of glucose and cortisol at time of hypoglycemia.