Is hypoglycemia really observed in pediatric beta-blocker intoxications? A case-control study

Area of Science:

• Toxicology
• Pediatric Emergency Medicine
• Clinical Chemistry

Background:

• Beta-blocker (BB) intoxications are common and can present with various symptoms, including cardiovascular effects and, less frequently, hypoglycemia.
• While cardiovascular effects are well-documented, the incidence of hypoglycemia in BB ingestions requires further investigation compared to other poisonings.

Purpose of the Study:

• To determine if hypoglycemia is more prevalent in beta-blocker (BB) intoxications compared to selective serotonin reuptake inhibitor (SSRI) poisonings.
• To compare blood glucose levels (BGLs) in pediatric patients with BB intoxication versus those with SSRI intoxication.

Main Methods:

• A case-control study was conducted in a pediatric emergency department.
• Group 1 included patients with BB poisoning, and Group 2 included patients with SSRI poisoning.
• Blood glucose levels (BGLs) were recorded at admission and at 1, 6, and 24 hours post-admission. Data were analyzed using SPSS, with t-tests, chi-square, and ANOVA.

Main Results:

• The study included 40 patients in each group (BB intoxication and SSRI intoxication).
• Mean BGLs in the BB intoxication group were lower at 1, 6, and 24 hours compared to the control group, with statistically significant differences at 1 and 24 hours (p < 0.001).
• Patients exposed to propranolol showed significantly lower BGLs than those who ingested other BBs. No correlation was found between BB toxic dose and BGLs.

Conclusions:

• Beta-blocker (BB) intoxications can result in lower blood glucose levels (BGLs), but these are generally not clinically severe.
• Despite not reaching critical levels, close monitoring of BGLs in all intoxication cases is advised.