Prevalence of hyperglycaemia in children seen at a paediatric emergency unit

ABSTRACT

Hyperglycaemia is known to be of common occurrence in paediatric emergency units, particularly in patients with severe disease. This study aimed to determine its prevalence and describe the disease conditions and clinical features associated with hyperglycaemia among children presenting to an emergency unit. A total of 1000 children aged 1 month to 14 years were enrolled in a cross-sectional study of prevalence of hyperglycaemia in two paediatric emergency units. In all cases, blood glucose (BG) level was determined, as well as clinical information. Hyperglycaemia was defined as blood glucose ≥7.8 mmol/l. The BG levels ranged between < 0.6 and 27.4 mmol/l (mean±standard deviation (SD) 6.5±3.0 mmol/l). Fever was seen in 84%, polyuria and polydypsia in 3%, cough in 33%, vomiting in 35%, and diarrhoea in 33% of patients. Hyperglycaemia was observed in 16.5% of the study children. The mean age of hyperglycaemic patients was 56±48 months. Children older than 6 years had the highest frequency of hyperglycaemia (33%), while infants had the lowest (14%). The only factor significantly associated with hyperglycaemia was a history of fever (p=0.001). Study subjects with gastroenteritis had the highest frequency of hyperglycaemia (4.4%), followed by severe malaria with 2.7%, and protein energy malnutrition (PEM) 2.3%. The mortality in hyperglycaemic children was higher than that in children with no hyperglycaemia (22.4% vs 7.5%, p=0.001). In conclusion, hyperglycaemia is not uncommon in emergency paediatric admissions, and it occurs more in patients with severe acute diseases. Children with hyperglycaemia should be monitored closely since they are at increased risk of death