Glucose metabolism in children: influence of age, fasting, and infectious diseases

Zijlmans, Wilco; Kempen, Anne A. M. W. van; Serlie, Mireille J.; Sauerwein, Hans P.

doi:10.1016/j.metabol.2009.04.020

Cited by 25 publications

(23 citation statements)

References 149 publications

(197 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although EGP is an important denominator of plasma glucose concentration in children,12 15 other factors, such as medical condition and nutritional status, strongly influence glucose homeostasis in hospitalised children 8 15. Critical illness-induced hyperglycaemia due to the metabolic response to stress, has been well established, and is associated with poor outcome 16 17.…”

Section: Discussionmentioning

confidence: 99%

Endogenous glucose production from infancy to adulthood: a non-linear regression model

Huidekoper

Ackermans

Ruiter

et al. 2014

Archives of Disease in Childhood

View full text Add to dashboard Cite

we present an accurate non-linear regression model for EGP as a function of age. With standard dextrose-based saline solutions infused at fluid maintenance rate, only approximately 50% or less of EGP is provided. With prolonged infusion of these solutions, the deficit between exogenous glucose supplementation and EGP may induce a catabolic state and may ultimately lead to hypoglycaemia, especially in younger children.

show abstract

Section: Discussionmentioning

confidence: 99%

Endogenous glucose production from infancy to adulthood: a non-linear regression model

Huidekoper

Ackermans

Ruiter

et al. 2014

Archives of Disease in Childhood

View full text Add to dashboard Cite

show abstract

“…Fasting is considered a major risk factor for hypoglycemia in children. Healthy children are able to maintain a normal plasma glucose concentration for up to 24 hours of fasting [71]. In the fasting state, plasma glucose levels are maintained within narrow limits by a delicate balance between endogenous glucose production that derives from both glycogenolysis, the breakdown of glycogen, and gluconeogenesis, the production of glucose from lactate, glycerol, or several amino acids and .glucose utilization.…”

Section: Fasting and Hypoglycaemiamentioning

confidence: 99%

Malaria-associated hypoglycaemia in children

Madrid¹,

Lanaspa²,

Maculuve³

et al. 2014

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

“…13 Hyperinsulinemia, secondary to parenteral quinine therapy, has been advanced as an iatrogenic cause and is well established in adults.…”

mentioning

confidence: 99%

“…10,12 Depletion of glucose stores caused by starvation, parasite use of glucose, and cytokineinduced impairment of gluconeogenesis have been implicated. 13 Hyperinsulinemia, secondary to parenteral quinine therapy, has been advanced as an iatrogenic cause and is well established in adults. 14,15 Hypoglycemia related to intoxication is probably another highly underestimated cause of death in the tropics.…”

mentioning

confidence: 99%

“…Moreover, hypoglycemia may be aggravated by several generally accepted risk factors such as the altered nutritional status, the severity of the infectious diseases, the young age, the delay in admittance to the hospital, the use of potentially toxic herbal preparations, and the lack of diagnostic facilities. 2,13 Younger children and neonates are particularly susceptible to hypoglycemia, both in tropical and western countries. 18 Undernourished children are prone to hypoglycemia any time their fragile nutritional balance is compromised.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Improving the Management of Dysglycemia in Children in the Developing World

Hubert¹,

Pussard²

2015

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Improving the availability of point-of-care (POC) diagnostics for glucose is crucial in resource-constrained settings (RCS). Both hypo and hyperglycemia have an appreciable frequency in the tropics and have been associated with increased risk of deaths in pediatrics units. However, causes of dysglycemia, including hyperglycemia, are numerous and insufficiently documented in RCS. Effective glycemic control with glucose infusion and/or intensive insulin therapy can improve clinical outcomes in western settings. A non-invasive way for insulin administration is not yet available for hyperglycemia. We documented a few causes and developed simple POC treatment of hypoglycemia in RCS. We showed the efficacy of sublingual sugar in two clinical trials. Dextrose gel has been recently tested for neonate mortality. This represents an interesting alternative that should be compared with sublingual sugar in RCS. New studies had to be done to document dysglycemia mechanism, frequency and morbid-mortality, and safe POC treatment in the tropics.Recently, Michael Hawkes and colleagues 1 reported the performance of point-of-care (POC) tests to guide the management of 179 children with severe malaria in a resource-limited Ugandan hospital. They paired measurements of glucose using i-STAT and OneTouch Ultra glucometer and other measurements for lactate and hemoglobin. Despite the small sample size of children with hypoglycemia and the lack of gold standard methods, they concluded that diagnostic tools, although imperfect, may expedite clinical decision-making in the management of critically ill children in resource-constrained settings (RCS). We completely agree with the crucial need for improving the availability of point-of-care diagnostics for glucose, particularly in RCS where hypoglycemia is a common and underdiagnosed cause of death.2-4 However, the sole diagnosis of dysglycemia is not sufficient if an access to effective therapy is not feasible, especially in the field for comatose children.For this purpose, we assessed the frequency of dysglycemia in sick children in non-malaria areas.2 In the pediatric ward of a referral hospital in Madagascar, an appreciable frequency (10.9%) (95% confidence interval [CI], 8.1-14.3) of hyperglycemic children at admission carried an increased risk of death (risk ratio [RR]: 2.2, 95% CI: 1-4.7).2 This association of hyperglycemia and increased mortality was described in rural Kenya and in a tertiary care hospital in India. 5,6 However, data on hyperglycemia frequency, causes, and mortality remains scarce in the tropics. 7,8 In the same study, we also found a 3.0% (95% CI, 1.6-5.2) prevalence of hypoglycemia among 420 consecutive children.2 Hypoglycemia was associated with increased risk of deaths (RR: 19.4, 95% CI: 5.0-74.7) after multivariate analyses. The rate of hypoglycemia was consistent with reports from Tanzania 9 but lower than rates reported in malaria areas. [5][6][7]10,11 Hypoglycemia is a common and serious complication in children with severe malaria, and it also is in...

show abstract

Glucose metabolism in children: influence of age, fasting, and infectious diseases

Cited by 25 publications

References 149 publications

Endogenous glucose production from infancy to adulthood: a non-linear regression model

Endogenous glucose production from infancy to adulthood: a non-linear regression model

Malaria-associated hypoglycaemia in children

Improving the Management of Dysglycemia in Children in the Developing World

Contact Info

Product

Resources

About