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Hyperglycemia in Acutely Ill Non-diabetic Children in the Emergency Rooms of 2 Tertiary Hospitals in Lagos, Nigeria

Journal article
Authors E. E. Oyenusi
A. O. Oduwole
A. S. Aronson
B. G. Jonsson
Kerstin Albertsson-Wikland
O. F. Njokanma
Published in Pediatric Emergency Care
Volume 32
Issue 9
Pages 608-613
ISSN 0749-5161
Publication year 2016
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 608-613
Language en
Links dx.doi.org/10.1097/pec.000000000000...
Keywords hyperglycemia, intravenous glucose, mortality, stress hyperglycemia, prevalence, childhood, mortality, diarrhea, glucose, insulin, classification, hypoglycemia, association, Emergency Medicine, Pediatrics
Subject categories Pediatrics

Abstract

Objectives The study aimed to determine the prevalence of hyperglycemia in sick children admitted into the emergency rooms and to investigate its relationship with adverse outcomes. Methods A prospective study involving 2 tertiary hospitals in Lagos. Study subjects included all children aged beyond 1 month. An Accu-Chek Active glucometer was used for the bedside blood glucose determination. Hyperglycemia was defined as blood glucose greater than 7.8 mmol/L. Results A total of 1045 patients were recruited with hyperglycemia being recorded in 135 patients (prevalence rate of 12.9%). Mean age of the hyperglycemic patients was 29.0 31.23 months. Prevalence rates of hyperglycemia among the leading diagnoses were 17.4% in acute respiratory tract infections, 11% in malaria, 15.3% in septicemia, 14.9% in gastroenteritis, and 18.2% in burns. Other conditions include sickle cell anemia, meningitis, and malnutrition. Mortality rate was significantly higher overall in hyperglycemic compared with the normoglycemic patients (15.4% vs 8.0%, P = 0.011). With regard to specific diagnoses, significantly higher mortality rates were recorded in hyperglycemic patients with acute respiratory tract infections (28% vs 8%, P = 0.011) and malaria (21.4% vs 5.0%, P = 0.006) than in their normoglycemic counterparts. Conclusions Hyperglycemia is common in ill children admitted to the emergency rooms and is associated with 2 to 4 times higher mortality in common childhood diseases encountered. Blood glucose determination is important in all acutely ill children at presentation. The practice of empirical administration of intravenous glucose in some resource-constrained facilities where blood glucose testing facilities are not readily available should be discouraged.

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