Resumo

AZUKA, N C; CHUKWUKA, J O; EBENEBE, J C  e  OFIAELI, O C. Hypoglycaemia in children aged 1 month to 17 years admitted to the children's emergency room of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. S. Afr. j. child health [online]. 2021, vol.15, n.1, pp.25-32. ISSN 1999-7671.  http://dx.doi.org/10.7196/sajch.2020.v15i1.1761.

BACKGROUND: Hypoglycaemia is a common presenting feature of illness among children admitted with various conditions into the paediatric emergency roomOBJECTIVE: To determine the prevalence of hypoglycaemia among children admitted into a Nigerian teaching hospital, identify some of its associated factors and assess its relationship to patient outcomeMETHODS: In this cross-sectional study, 388 children were consecutively recruited. Their sociodemographic characteristics, clinical features and management outcome were obtained. Plasma glucose was measured using the glucose oxidase method and classified as hypoglycaemia (<3.4 mmol/L), low glycaemia (3.4 - <4.4 mmol/L) , normoglycaemia (4.4 - 7.7 mmol/L) and hyperglycaemia (>7.8 mmol/LRESULTS: Hypoglycaemia occurred in 50 (12.9%) subjects, while 55 (14.2%) had low glycaemia. At bivariate analysis, hypoglycaemia was associated with age (p=0.012), >6 hours from the last meal (p=0.004), medication use before presentation (p=0.014) and some markers of illness severity such as loss of consciousness (p<0.001), respiratory distress (p=0.004), dehydration (p=0.002), shock (p=0.004), and hypoxia (p=0.001). After logistic regression, a time > 6 hours from last meal (adjusted odds ratio (aOR) 2.98; 95% confidence interval (CI) 1.27 - 6.98), hypoxia (aOR 3.10; 95% CI 1.39 - 6.90), and passage of watery stools (aOR 2.92; 95% CI 1.26 - 6.78) were associated with hypoglycaemia. Hypoglycaemic subjects were 2.9 times more likely to die than normoglycaemic ones (p<0.001) but this association was lost at multivariable analysisCONCLUSION: Hypoglycaemia complicates common childhood illnesses and may be associated with poorer outcomes. Plasma glucose measurement and subsequent appropriate action should be core parts of the immediate management of ill children

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