Prediabetic markers in children with stress hyperglycemia

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D M Bhisitkul1, A I Vinik, A L Morrow

  • 1Division of Pediatric Emergency Medicine, Children's Hospital of the King's Daughters, Norfolk, VA 23507, USA.

Archives of Pediatrics & Adolescent Medicine
|September 1, 1996
PubMed

Insights

Children with stress hyperglycemia do not show increased risk for type 1 diabetes. Study found no increased immunologic or genetic markers, suggesting stress hyperglycemia is not a prediabetic state in children.

Area of Science:

  • Pediatric Endocrinology
  • Immunology
  • Genetics

Background:

  • Previous research linked stress hyperglycemia in children to an increased risk of developing type 1 diabetes (insulin-dependent diabetes mellitus).
  • The potential for stress hyperglycemia to indicate a prediabetic state in pediatric patients required further investigation.

Purpose of the Study:

  • To determine if stress hyperglycemia in prospectively screened pediatric patients signifies a prediabetic state.
  • To investigate the presence of immunologic and genetic markers associated with type 1 diabetes in hyperglycemic children.

Main Methods:

  • A prospective cohort study screened pediatric patients for hyperglycemia (blood glucose ≥ 8.3 mmol/L).
  • Hyperglycemic patients were age-matched with stress control (acutely ill, non-hyperglycemic) and healthy control subjects.
  • Blood samples were analyzed for islet cell antibodies, insulin autoantibodies, GAD antibodies, and HLA-DQB1 genotypes.

Main Results:

  • No patients or controls tested positive for islet cell antibodies.
  • Insulin autoantibodies were found in four subjects with sickle-cell disease and fever, but not in others.
  • No increased prevalence of diabetes-associated HLA-DQB1 genotypes was observed in the hyperglycemic group.
  • Follow-up at 31–36 months showed no development of type 1 diabetes in any group.

Conclusions:

  • Children experiencing stress hyperglycemia do not exhibit a higher prevalence of immunologic or genetic markers for type 1 diabetes.
  • The findings suggest that stress hyperglycemia in children is unlikely to be a prediabetic state.
  • Insulin autoantibodies may develop in children experiencing sickle cell crises.
Abstract

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