Objectives:To determine the incidence and study association of hyperglycemia with outcome of critically ill children.Setting and Design:This was a prospective observational study conducted in eight bedded pediatric intensive care unit (PICU) of a tertiary care hospital.Materials and Methods:One hundred and one critically ill non-diabetic children between ages of 1 month to 16 years were studied from the day of admission till discharge or death. Serial blood sugars were determined first at admission, thereafter every 12 hourly in all children. Blood glucose level above 126 mg/dl (>7 mmol/dl) was considered as hyperglycemia. Children with hyperglycemia were followed 6 hourly till blood glucose fell below 126 mg/dl. Hyper and non-hyperglycemic children were compared with respect to length of stay, mechanical ventilation, use of inotrops and final outcome. Survivors and non-survivors were compared in relation to admission blood glucose, peak blood glucose level and duration of hyperglycemia.Results:Seventy (69.3%) children had hyperglycemia. Requirement of ventilation [(23) 32.9% vs.(3) 9.7%], requirement of inotropic support [(27) 38.6% vs.(5) 16.1%], Mean length of stay in PICU (7.91 ± 5.01 vs. 5.58 ± 1.95 days) and mortality (28.6% vs. 3.2%) among hyperglycemic children was significantly higher (P < 0.05) than that of non-hyperglycemic. Logistic regression analysis showed Peak blood glucose level and duration of hyperglycemia has independent association with increased risk of death.Conclusion:Incidence of hyperglycemia is high in critically ill children and it is associated with high morbidity and mortality.

BACKGROUND Objective-To compare clinical presentation and risk factors for the development of stroke in diabetics and non-diabetics population. MATERIALS AND METHODS In this comparative, descriptive study, adult diabetic patients (< 18 years of age) with acute stroke were enrolled. Non-diabetic stroke patients acted as controls. Patients were followed up for > 3 months at regular intervals. RESULTS Eighty patients [diabetic n= 40 (mean age 55 yrs.) and non-diabetic n= 40 (mean age 58.92 yrs)] were included. History of motor weakness was the most common presenting complaint in both groups. Among diabetics 87.5% were known diabetics; 67% diabetics had history of hypertension compared to 27% non-diabetics (p < 0.05). Mean Blood Pressure (BP) on admission was higher in diabetics (systolic BP 155.47 vs 137.61 mmHg; p < 0.05; diastolic BP 92.02 vs 85.60; p < 0.05). Random Blood Sugar (RBS) and triglyceride level was significantly more in diabetics, whereas HDL level was significantly more in non-diabetics. Rates of infarction were higher in diabetics [25 (65%) vs 13 (33%); p < 0.05], whereas haemorrhagic stroke was common in non-diabetics [27 (67%) vs 14 (35%); p < 0.005]. A total of 26 (65%) patients had fair recovery in diabetic group, whereas 10 (25%) had poor recovery. Mortality rate was 10% in both the groups. Overall outcome was better in the non-diabetic stroke patients. Mean RBS of people who died due to diabetes was significantly higher compared to those in the non-diabetics. CONCLUSION Stroke type, prevalence of risk factors and outcome of stroke in diabetes differs from that in non-diabetics.