Hypoglycaemia in children aged 1 month to 10 years admitted to the Children’s Emergency Centre of Lagos University Teaching Hospital, Nigeria

Abstract

Background. Hypoglycaemia occurs in many disease states common in the tropics, and may also complicate treatment of malaria. It may contribute significantly to morbidity and mortality.
Objectives. To determine the prevalence of and clinical conditions associated with hypoglycaemia.
Methods. A total of 430 patients aged 1 month to 10 years were recruited consecutively from the Children’s Emergency Centre of Lagos University Teaching Hospital. Clinical and demographic data were entered into a predesigned study proforma. Blood glucose was determined in the laboratory using the glucose oxidase method. Hypoglycaemia was defined as plasma glucose <2.5 mmol/L.
Results. The median age of the study subjects was 24 months, with a range of 1.5 - 120 months. A total of 248 patients (57.6%) were <24 months old. The mean (standard deviation) blood glucose of all the study subjects was 5.19 (2.05) mmol/L (median 4.9 mmol/L). Twenty-four patients (5.6%) were hypoglycaemic. The predominant disease conditions in which hypoglycaemia occurred were severe malaria, multisystemic infections, marasmus, malignancies and gastroenteritis. Mortality was higher in hypoglycaemic patients than in those without hypoglycaemia (33.3% v. 5.4%, p<0.01).
Conclusion. Hypoglycaemia complicates many common childhood illnesses seen in the emergency room and is associated with significant mortality. Hypoglycaemia should be suspected in severely ill children with severe malaria, multisystemic infections, marasmus, malignancies and gastroenteritis.