Related Experiment Video

Updated: Sep 17, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

19.0K

The association between stress hyperglycemia and poor outcome in critically ill children is modulated by

Wenjun Liu1, Milan Dong2, Jing Li1

  • 1Department of Critical Care Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China.

Frontiers in Endocrinology
|July 3, 2025
PubMed

Insights

Hyperlactatemia (HL) modulates stress hyperglycemia (SHG) in critically ill children. Combined SHG and HL predict poor outcomes, while SHG alone does not, suggesting tailored glucose targets are needed.

Area of Science:

  • Pediatric Critical Care Medicine
  • Metabolic Regulation in Critical Illness
  • Biomarker Interactions in Pediatric Patients

Background:

  • Evidence on optimal glycemic control in critically ill children is conflicting.
  • The interplay between glucose and lactate levels and their impact on outcomes in pediatric critical care remains poorly understood.

Purpose of the Study:

  • To investigate the role of hyperlactatemia (HL) in modifying the association between stress hyperglycemia (SHG) and adverse outcomes.
  • To inform the development of individualized glucose management strategies for critically ill children.

Main Methods:

  • Secondary analysis of a prospective observational cohort study in five Chinese Pediatric Intensive Care Units (PICUs).
  • Examined interaction effects between glucose and lactate metrics on patient outcomes.
  • Defined SHG as glucose > 150 mg/dL and HL as lactate > 2 mmol/L.

Main Results:

  • Analysis included 433 pediatric patients and 4885 blood gas measurements; 20.8% mortality within 28 days.
  • Significant interaction between SHG and HL on outcomes (p < 0.05).
  • In the presence of HL, SHG independently predicted 28-day mortality (OR 3.55) and reduced ventilator-free and ICU-free days. SHG alone did not predict mortality or reduced free days.

Conclusions:

  • Hyperlactatemia appears to modulate the relationship between stress hyperglycemia and poor outcomes in critically ill children.
  • The combination of SHG and HL is associated with adverse outcomes, whereas SHG in the absence of HL is not.
Abstract

Keywords:
childrencritically illhyperlactatemiaoutcomestress hyperglycemia

More Related Videos

Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique07:35

Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique

Published on: January 26, 2024

1.6K
A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia09:35

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia

Published on: November 15, 2024

529

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
349
Overview of Carbohydrate Metabolism01:19

Overview of Carbohydrate Metabolism

Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
1.9K
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
1.2K
Psychoneuroimmunology: Diabetes and Cancer01:19

Psychoneuroimmunology: Diabetes and Cancer

Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
66
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
702
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
3.0K