Incidence of Hypoglycaemia in a Paediatric Emergency Ward in Nigeria

Hypoglycaemia in children aged 1 month to 17 years admitted to the children’s emergency room of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

“…[3] Hypoglycaemia is a common presenting feature among children admitted with various conditions to the paediatric emergency room or intensive care unit. [4][5][6][7][8][9][10][11][12][13] Non-African studies found that it complicates as much as 9.7 -18.6% of childhood illnesses. [8,9] In some African countries, prevalence of hypoglycaemia among ill children ranges from 3.1 -7.3%, [4,7] while in Nigeria it is as high as 5.1 -20.7%.…”

“…[8,9] In some African countries, prevalence of hypoglycaemia among ill children ranges from 3.1 -7.3%, [4,7] while in Nigeria it is as high as 5.1 -20.7%. [5,6,[10][11][12][13] Infants and younger children are more susceptible to hypoglycaemia than adults owing to a lower glycogen store, a substantially smaller muscle bulk relative to body mass, and greater glucose requirements per unit of body mass. [2,3] Other risk factors for the development of hypoglycaemia include a time >4 -12 hours from the last meal, [5][6][7]12] infectious diseases [5,10] and some disease severity markers such as deep coma and severe malnutrition.…”

“…[5,6,[10][11][12][13] Infants and younger children are more susceptible to hypoglycaemia than adults owing to a lower glycogen store, a substantially smaller muscle bulk relative to body mass, and greater glucose requirements per unit of body mass. [2,3] Other risk factors for the development of hypoglycaemia include a time >4 -12 hours from the last meal, [5][6][7]12] infectious diseases [5,10] and some disease severity markers such as deep coma and severe malnutrition. [5,7] Hypoglycaemia presents with nonspecific symptoms, usually classified as adrenergic and neuroglycopenic symptoms.…”

“…[2] Hypoglycaemia has been found to significantly increase morbidity and mortality among severely ill children both in Africa and North America. [4][5][6]8,[11][12][13] The majority of Nigerian studies on the prevalence rate and pattern of hypoglycaemia among children admitted into the emergency room were at cut-off values of blood glucose concentration <2.2 mmol/L or plasma glucose concentration <2.5 mmol/L, which were acceptable at the time as the definition for hypoglycaemia but at which point complications, especially neurological sequelae, may have set in. [5,6,[10][11][12] Concerns to avoid these complications arising from hypoglycaemia, especially neurological sequelae, have caused the bar to be raised in the definition of hypoglycaemia, to blood glucose <3.1 mmol/L (55 mg/dL), [2] and plasma glucose <3.4 -3.5 mmol/L (60.5 -63.3 mg/dL).…”

“…[4][5][6]8,[11][12][13] The majority of Nigerian studies on the prevalence rate and pattern of hypoglycaemia among children admitted into the emergency room were at cut-off values of blood glucose concentration <2.2 mmol/L or plasma glucose concentration <2.5 mmol/L, which were acceptable at the time as the definition for hypoglycaemia but at which point complications, especially neurological sequelae, may have set in. [5,6,[10][11][12] Concerns to avoid these complications arising from hypoglycaemia, especially neurological sequelae, have caused the bar to be raised in the definition of hypoglycaemia, to blood glucose <3.1 mmol/L (55 mg/dL), [2] and plasma glucose <3.4 -3.5 mmol/L (60.5 -63.3 mg/dL). [2] The present study sought to determine the prevalence of hypoglycaemia among children admitted into the children's emergency room of a typical Nigerian teaching hospital, at a plasma glucose cut-off value <3.4 mmol/L, identify some of its associated Background.…”