Determinants and outcome of dysglycaemia in a children emergency ward, south-west Nigeria
Keywords:
Dysglycaemia, Hypoglycaemia, Hyperglycaemia, Children Emergency, NigeriaAbstract
Introduction: Dysglycaemia is an abnormal blood glucose concentration. It is not uncommon in acutely ill children and could lead to significant preventable complications. This study evaluates its determinants and outcome in a children emergency ward.
Method: The study was carried out at the Children Emergency Unit of Teaching Hospital, Osogbo. One hundred and one consecutive ill children, aged one month to 14 years were studied. At admission, blood glucose was determined. Patients were managed and followed up to determine duration of hospital admission and immediate outcomes.
Result: 56 (55.4%) were males and 45 (44.6%) were females, giving a male: female ratio of 1.24: 1. The mean ages of the patients was 40.83 (3.65) months. The blood glucose of the patients ranged from 1.60 to 10.20mmol/L with a mean of 5.19 (1.42) mmol/L. Eleven (10.9%) of the patients had dysglycaemia comprising 3 (27.3%) with hypoglycaemia and 8 (72.7%) with hyperglycaemia. The remaining 90 (89.1%) patients had normoglycaemia. Of the 3 patients with hypoglycaemia, severe malaria was the commonest diagnosis, while respiratory infection was the commonest among the 8 patients with hyperglycaemia. The mean duration of admission was longest among patients with hyperglycaemia. Four (4.5%) of the 90 patients with normoglycaemia had varying complications, the outcome is worse in patients with hypoglycaemia compared to those with normoglycaemia (p= 0.012).
Conclusion: In conclusion, dysglycaemia occurred among acutely ill children with prevalence of 10.9%. Worsening morbidity could be associated with dysglycaemia. There was apparent poorer outcome in patients with hypoglycaemia.
References
Sambany E, Pussard E, Rajaonarivo E, Raobinjaona H, Barennes H. Childhood Dysglycemia: Prevalence and outcome in a referral hospital. PLOS ONE. 2013; 8: e65193. doi:10.1371/journal.pone.0065193.
Ameyaw E, Amponsah-Achiano K, Yamoah P, Chanoine J. Abnormal blood glucose as a prognostic factor for adverse clinical outcome in children admitted to the Paediatric emergency unit at Komfo Anokye Teaching Hospital Kumasi, Ghana. Int J Pediatr; 2014:1-6.
Christi MJ, Ahmed T, Ashraf H, Faruque ASG, Huq S, Hussain M. Hypoglycemia in children attending the critical care medicine in developing countries, Diabetes-Damages and Treatments. Prof. Everlon Rigobelo (Ed.), ISBN: 978-953-307-652-2, InTech. DOI:10.5772/23406. Available from http://www.intechopen.com/books/diabetes-damages-and-treatmens/hypoglycaemia-in-developing-countries. Accessed 1st September 2015.
Hay WW, Levin MJ, Sondheimer JM, Deterding RR. Hypoglycemia. In: Current Diagnosis & Treatment. Pediatrics 20thEdition. McGrav-Hill Co; 2011.1:18-19.
Hay WW, Sparks JW. Placental foetal and neonatal carbohydrate metabolism. Clin Obstet Gynecol. 1985; 28:4730-4785.
White NJ, Miller KD, Marsh KK, Berry CD, Turner RC, Williamson DH, et al. Hypoglycemia in African Children with Severe Malaria. Lancet. 1987; 1:708-711.
World Health Organization. Pocket Book of Hospital Care for Children: Guidelines For the Management of Common Childhood Illnesses. 2nd Edition. WHO 2013.
Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R et al. Controversies Regarding Definition of Neonatal Hypoglycemia: Suggested Operational Thresholds. Pediatrics. 2000; 105:1141-1145.
Osier FH, Berkley JA, Ross A, Sanderson F, Mohammed S, Newton CR. Abnormal Blood Glucose Concentrations on Admission to A Rural Kenyan District Hospital: Prevalence and Outcome. Arch Dis Child. 2003; 88: 621-625.
Elusiyan JB, Adejuyigbe EA, Adeolu OO. Hypoglycaemia in a Nigerian Paediatric Emergency ward. J Trop Pediatr. 2006; 52:96-102.
Oluwayemi IO, Ogundare EO, Ajite AB, Raimi TH. Profile of Random Blood glucose of Children Seen at the Children Outpatient Department of Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Glob J Endocrinol Metab. 2018; 1:1-4.
Zijlmans WCWR, vanKempen AAMW, Ackermans MT, de Metz J, Kager PA, Sauerwein HP. Very young children with uncomplicated falciparum malaria have higher risk of hypoglycaemia: a study from Suriname. Trop Med Int Health. 2008;13: 623-34.
Schellenberg D, Menendez C, Kahigwa E, Font F,Galindo C, Acosta C. African children with malaria in an area of intense Plasmodium Falciparum transmission: Features on admission to the hospital and risk factors for death. Am J Trop Med Hyg. 1999; 61:431-438.
American Diabetes Association. Diabetes Care. 2000; 23:54-519.
World Health Organisation. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO Consultation. Geneva: 59p WHO/NCD/NCS/99.2;1999. Accessed 1st September 2015.
Faustino EV, Apkon M. Persistent hyperglycemia in critically ill children. J Pediatr. 2005;146:30-34.
Araoye MO. Subject Selection. Araoye MO editors. Research Methodology with Statistics for health and social sciences 2nd edition, Ilorin; Nathadex 2004: 115-120.
Accuchek Active®Blood Glucose Meter [user’s manual]. Mannheim, Germany: Roche Diagnostics; 2013.
Toggle DW, Kuhn MA, Jones SK, Garza JJ, Skinner S. Hyperglycemia and infections in pediatric trauma patients. Am Surg. 2008; 74:195-198.
Kliegman RM, Berhrman RE, Jensen HB, Stanton BF. Hypoglcemia In: Nelson textbook of Pediatrics, 18th ed. Philadelphia, Saunders Elsevier; 2007: 655-668.
Soro-Coulibaly T, Oduwole A, Tayo A, De Beaufort C, Oyenusi E, Abodo J, et al. Blood glucose profile in acutely ill children, Abobo North General Hospital, Cote d’lvoire AJDM. 2018; 1:26-32.
Oyenusi EE, Oduwole AO, Oladipo OO, Njokanma OF, Esezobor CI. Hypoglycaemia in children aged 1month to 10years admitted to the Children’s Emergency Centre of Lagos University Teaching Hospital, Nigeria. S Afr J C H. 2014;8:107-111.
Okoronkwo NC, Eke FU, Oruamabo RS. Hypoglycaemia among children presenting to emergency paediatrics unit of Abia University Teaching Hospital, Aba, Nigeria. .Int J Med Health Sci. 2013; 2:410-418.
Usman AD, Aishatu YM, Abdullahi B. Laboratory assessment of hypoglycaemia due to malaria in children attending general hospital Katsina. Bayero J Pure Applied Sci. 2008; 1: 6-9
Kawo NG, Msengi AE, Swai AB, Chuwa LM, Albertti KG, McLarty DG. Specificity of hypoglycaemia for cerebral malaria in children. Lancet. 1990; 336:454-457.
Wilcox ML, Forster M, Dicko MI, Graz B, Mayon-White R, et al. Blood glucose and prognosis in children with presumed severe malaria: Is there a threshold for ‘hypoglycaemia’? Trop Med Int Health. 2010; 15:232-340.
WHO. Management of the child with a serious infection or severe malnutrition. Guidelines at the first referral level in developing countries. Geneva. World Health Organisation 2000.
Poddar B. Treating hyperglycemia in the critically ill Child: Is there enough evidence? Indian Pediatr. 2011; 48:531-536.
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