Abstract
Background: stress hyperglycemia (SH) is a relatively frequent finding in pediatric patients. The purpose of this prospective observational study was to identify the prevalence of pediatric SH and its associated risk factors in Greece. Methods: A total of 1005 patients without diabetes who were admitted consecutively for acute illness in a Pediatric Emergency Department were included in the study. Medical history, anthropometric measurements, blood glucose levels, and the medication administered were recorded. A questionnaire was distributed to parents regarding medical and perinatal history and sociodemographic characteristics. Results: There were 72 cases of SH on admission (7.2%) and 39 (3.9%) during hospitalization. Mean age was 6.4 years; 50.3% were male. SH on admission was associated with oral corticosteroid therapy (21.1% vs. 4.7%, p < 0.001), inhaled corticosteroids (12.7% vs. 3%, p < 0.001), and inhaled β2-agonists (30.6% vs. 10.7%, p < 0.001). In-hospital hyperglycemia was associated with oral corticosteroids (adjusted OR = 3.32), inhaled corticosteroids (OR = 10.03) and inhaled β2-agonists (OR = 5.01). Children with asthma were 5.58 and 7.86 times more likely to present admission and in-hospital hyperglycemia, respectively. Conclusions: This is the first report of SH prevalence in pediatric patients in Greece. Asthma, corticosteroids, and β2-agonists significantly increase the risk of SH. No parental factors seem to predispose to SH.
Highlights
According to the latest American Diabetes Association and American Association of Clinical Endocrinologists consensus, stress hyperglycemia (SH) is defined as any transient inpatient plasma glucose levels >140 mg/dL under conditions of acute physical or psychological stress, without evidence of previous diabetes [1]
In more critical illness and, especially, in the intensive care unit (ICU) setting, incidence can reach as high as 60%, and it has been estimated that glucose levels above 200 mg/dL occur in 20–35% of critically ill children [5,6]
Our study aimed to examine the prevalence of stress hyperglycemia and its possible causes in acutely ill children
Summary
According to the latest American Diabetes Association and American Association of Clinical Endocrinologists consensus, stress hyperglycemia (SH) is defined as any transient inpatient plasma glucose levels >140 mg/dL under conditions of acute physical or psychological stress, without evidence of previous diabetes [1]. The incidence of SH has been reported to be as high as 5% in children presenting to pediatric emergency departments (EDs), with blood glucose concentrations ranging between 150 and 299 mg/dL in most cases [4]. In more critical illness and, especially, in the intensive care unit (ICU) setting, incidence can reach as high as 60%, and it has been estimated that glucose levels above 200 mg/dL occur in 20–35% of critically ill children [5,6]. The aim of this study was to determine the incidence of SH in a Greek cohort of patients admitted to the ED of a tertiary pediatric referral center in Athens, and to investigate its causes and possible risk factors regarding both patients themselves and parental characteristics
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