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Hyperglycaemia in infantile gastroenteritis
Insights
Hyperglycaemia (high blood sugar) affected 55% of black infants hospitalized for gastroenteritis. Intravenous rehydration, not insulin, normalized blood glucose and stress hormone levels within 48 hours.
Area of Science:
- Pediatrics
- Endocrinology
- Gastroenterology
Background:
- Gastroenteritis is a common cause of hospitalization in infants.
- Hyperglycaemia can occur in infants with severe illness.
- The underlying mechanisms of hyperglycaemia in this context are not fully understood.
Purpose of the Study:
- To investigate the prevalence and pathogenesis of hyperglycaemia in black infants with gastroenteritis.
- To identify potential contributing factors to hyperglycaemia in these patients.
Main Methods:
- A consecutive series of 27 black infants admitted with gastroenteritis were studied.
- Plasma glucose and stress hormone concentrations were measured.
- Hypokalaemia and insulin resistance were assessed.
Main Results:
- Hyperglycaemia (plasma glucose > 10 mmol/l) was observed in 15 (55%) of the infants.
- Possible contributing factors included elevated stress hormones (glucagon, growth hormone, cortisol), hypokalaemia, and insulin resistance.
- Intravenous rehydration alone corrected hyperglycaemia and normalized hormone levels within 36–48 hours.
Conclusions:
- Hyperglycaemia is common in black infants hospitalized with gastroenteritis.
- Stress hormones, hypokalaemia, and insulin resistance may play a role in its pathogenesis.
- Intravenous rehydration is an effective treatment for correcting hyperglycaemia in this population.
Abstract:
The prevalence and pathogenesis of hyperglycaemia were investigated in a consecutive series of 27 black infants admitted to hospital with gastroenteritis over a period of three months. Hyperglycaemia (plasma glucose concentration greater than 10 mmol/l) occurred in 15 (55%) of these patients. The pathogenesis was not clear but possible contributory factors included raised concentrations of the stress hormones pancreatic glucagon, growth hormone, and cortisol; hypokalaemia; and peripheral insulin resistance. Intravenous rehydration, without insulin, corrected the plasma glucose concentrations and restored the hormonal profile towards normal within 36 to 48 hours.