Reliability of bedside blood glucose estimating methods in detecting hypoglycaemia in the children’s emergency room

Oyenusi, EE; Oduwole, Abiola; Oladipo, OO; Njokanma, OF; Esezobor, Christopher Imokhuede

doi:10.4314/njp.v42i1.8

Cited by 3 publications

(7 citation statements)

References 8 publications

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“…This finding is in contrast to that of Ile-Ife 39 where severa malaria, sepsis, pneumonia and malnutrition were found to be associated with hypoglycaemia and to that of Lagos 38 where severe malaria, sepsis, marasmus and diarrhoeal disease were found to be associated with hypoglycaemia. In Mozambique 40 hypoglycaemia was found to be significantly associated with severe malaria, protein energy malnutrition, and pneumonia.…”

Section: Discussioncontrasting

confidence: 54%

“…The study reveals that whilst the prevalence of hypoglycaemia was low at 2.8%, that of hyperglycaemia was high at 8.2%. The prevalence of hypoglycaemia of 2.8% in this study was lower than the 5.6% and 6.4% in a cohort of Nigerian children admitted at the emergency paediatric units in Lagos 38 and Ile-Ife 39 respectively. In other settings outside Nigeria, the prevalence of hypoglycaemia of 2.8% in this study was lower than the respective 7.1% and 8.2% among paediatric admissions in Mozambique 40 and in Kenya 30 .…”

Section: Discussionmentioning

confidence: 54%

“…However, the absence of these clinical symptoms does not always indicate that the glucose concentration is normal or that it has not fallen below optimal level for brain metabolism 38 . Although subjects with oral thrush may be expected to eat poorly, this alone cannot explain the association with hypoglycaemia as "food refusal", surprisingly, was not found to be associated with hypoglycaemia in these subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from Lagos and Ile-Ife studies which used a higher cut-off value of less than 2.5 mmol/l to define hypoglycaemia, the Kenyan 30 and Mozambique 40 studies utilized the same value of less than 2.2 mmol/l with ours, thereby underscoring the fact that the prevalence of hypoglycaemia was in fact higher in their own cohorts 30,40 . In making comparisons however, caution must be exercised because of differences in the composition of the subjects that populated the different studies 30,[38][39][40] . Ours was essentially among HIV-infected ARTnaïve children.…”

Section: Discussionmentioning

confidence: 99%

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A retrospective analysis of dysglycaemia and its risk factors in a cohort of human immunodeficiency virus infected antiretroviral therapy naïve children in Makurdi, Nigeria

Anígilájé

2017

Sri Lanka J Child Health

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Background: Human immunodeficiency virus (HIV) endocrinopathy involving the pancreas manifests clinically as dysglycaemia, including hypoglycaemia and hyperglycaemia. Dysglycaemia increases mortality in sick children, underlying the need for its evaluation and management.Objective: To assess the prevalence and risk factors of dysglycaemia in a cohort of antiretroviral therapy (ART)-naïve children at the point of enrolment into a paediatric ART clinic of the Federal Medical Centre, Makurdi, Nigeria. Method:A retrospective cross-sectional study was carried out between June 2010 and June 2012. Hypoglycaemia was defined as random blood glucose level ˂2.2 mmol/l and hyperglycaemia as random blood glucose ˃6.6 mmol/l. Potential risk factors of dysglycaemia were tested for significance in bivariate and multivariate regression analyses. Pvalue less than 0.05 was considered to be significant.Results: 429 children, aged 1-15 years, including 223 males and 206 females were studied. The median age was 5 years. Twelve (2.8%) children had hypoglycaemia and 35 (8.2%) had hyperglycaemia. In multivariate regression analysis, no factor significantly predicted the risk of hypoglycaemia, whereas children co-infected with hepatitis C were at a significant risk of hyperglycaemia (adjusted odds ratio; 2.06, 95% CI; 1.05-8.52, P=0.03). Conclusions:In this study HIV-infected Nigerian children who were not on ART had a low prevalence of hypoglycaemia but a high prevalence of hyperglycaemia. Hepatitis C co-infection was a significant independent risk factor for hyperglycaemia. _________________________________________

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A retrospective analysis of dysglycaemia and its risk factors in a cohort of human immunodeficiency virus infected antiretroviral therapy naïve children in Makurdi, Nigeria

Anígilájé

2017

Sri Lanka J Child Health

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“…This is very important because most times, hypoglycaemia is asymptomatic and when symptoms are present, they are non-specific. Bedside meters have been validated and found to be highly sensitive and specific for diagnosing hypoglycaemia in studies by the authors 76,77 . A brand of glucometer was found to have a sensitivity of 96.00% (95% CI =81.81%-99.80%) and a specificity of 96.46% (95% CI=94.17%-98.02%).…”

Section: Diagnostic Work Upmentioning

confidence: 99%

Hypoglycaemia in children: Review of the literature

Elusiyan¹,

Oyenusi²

2016

Nig. J. Paed.

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Hypoglycaemia is a common metabolic condition in children. It often presents urgent and therapeutic challenges and it has been documented to affect many childhood conditions. Its clinical presentation is not classical and requires a high index of suspicion for an early diagnosis and prompt management. Undiag-nosed or undertreated hypoglycaemia has been found to increase mortality in children when it is present. This review sought to review the subject of hypoglycaemia in children and calls for testing for it in all sick and admitted children.

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Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu

et al. 2017

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BackgroundCritically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay.MethodsAnalytical cross sectional method was used to study critically ill children aged ≥1 month to ≤10 years admitted into the Children Emergency Room of Enugu State University Teaching Hospital, Enugu. Their admission blood glucose was done. Interviewer administered questionnaire was used to collect information including sociodemographics, duration of hospitalization and outcome of treatment. Data was analysed using SPSS version 20. Chi square, logistic regressions and Kruskal Wallis tests were done as appropriate.ResultsA total of 300 patients were recruited. One hundred and seventeen (39%) had hyperglycemia, 62 (20.7%) patients had hypoglycaemia and 121 (40.3%) had euglycemia. Two hundred and fifty two (84%) were discharged while 48 (16%) died. There was significant association between glycemic levels and treatment outcome (p = < 0.001). Among the 48 who died, 12 (25.0%) had euglycemia, 21 (43.75%) had hypoglycaemia while 15 (31.25%) had hyperglycemia. On multivariate analysis, there was statistically significant association between hypoglycaemia and mortality (p = < 0.001). Unadjusted, those children with hypoglycaemia at presentation were about 4.7 times (UOR = 0.21, 95% Cl: 0.08–0.38) and adjusted, about 5 times (AOR = 0.20, 95% CI: 0.09–0.47) less likely to survive compared with those with euglycemia. Although not statistically significant, those with hyperglycemia were about 1.3 times less likely to survive compared with euglycemic children, adjusted and unadjusted (UOR = 0.75, 95% Cl: 0.33–1.68).ConclusionWhile both hypo- and hyperglycemia are associated with mortality, hypoglycaemia had a greater effect than hyperglycemia. Glycemic levels significantly affects treatment outcome.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0879-8) contains supplementary material, which is available to authorized users.

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Reliability of bedside blood glucose estimating methods in detecting hypoglycaemia in the children’s emergency room

Cited by 3 publications

References 8 publications

A retrospective analysis of dysglycaemia and its risk factors in a cohort of human immunodeficiency virus infected antiretroviral therapy naïve children in Makurdi, Nigeria

A retrospective analysis of dysglycaemia and its risk factors in a cohort of human immunodeficiency virus infected antiretroviral therapy naïve children in Makurdi, Nigeria

Hypoglycaemia in children: Review of the literature

Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu

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