Analysis of relationship between stress hyperglycemia and variation of serum insulin in critical ill children

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Objective To study the relationships between the level of blood glucose in critical ill children with the degree of critical illness and the variation of immunoreactive insulin (IRI) and true insulin(TI). Methods Fifty-eight children form the Neonatal Intensive Care Unit (PICU) and Department of Respiration were enrolled in this study.The children were divided into PICU group (42 cases) and control group (16 cases). The PICU group were scored pediatric critical score in 24 hours after admission.The 42 critical ill children were divided into stress hyperglycemia group (20 cases) and non-stress hyperglycemia group (22 cases) according to their blood glucose levels.The IRI, TI, C-Peptide and blood glucose were measured. Results The pediatric critical illness score of stress hyperglycemia group [(74.80±8.07)scores] was significantly lower than that of non-stress hyperglycemia group [(84.36±9.46) scores](t=1.964, P<0.05) .The death rate of stress hyperglycemia group (45.0%, 9/20 cases) was significantly higher than that of non-stress hyperglycemia group (13.6%, 3/22 cases)(χ2=5.05, P<0.05). The IRI, TI and C-Peptide of stress hyperglycemia group were significantly higher than those of non-stress hyperglycemia group and control group(F=136.90, 61.25, 45.89, all P<0.05). The TI/IRI of stress hyperglycemia group was significantly lower than that of non-stress hyperglycemia group and control group (F=27.64, P<0.05). The TI, IRI and C-Peptide of stress hyperglycemia group were higher than after admission (t=2.241, 2.087, 2.014, all P<0.05). Conclusions The children with critical illness have stress hyperglycemia and the component of insulin is changed, and the absolute level as well as the rate of TI and TI/IRI are descended. Key words: Critical illness; Immunoreactive insulin; True insulin; Stress hyperglycemia