Evaluation of Stress Hyperglycemia on the Admission and Follow-up of Patients Admitted to the Pediatric Emergency Department

Year 2025, Volume: 1 Issue: 2, 83 - 89, 01.09.2025

Aslan Ali Kırgın , Yüksel Yaşartekin , Ayşe Derya Buluş , Ugur Ufuk Isin

Abstract

Aim: This study aims to examine the demographic and clinical characteristics of patients with stress hyperglycemia (SH) at admission to the pediatric emergency department and investigate whether diabetes develops in the follow-up of patients with SH.
Material and methods: Data were collected retrospectively from the medical records of all children aged 1 month –18 years who visited the Pediatric Emergency Department during the years 2017–2022 and had a glucose level of >200 mg/dl.Patients with a final diagnosis or history of diabetes mellitus were excluded from the study. Data collected included age, gender, blood glucose level, treatment with medications affecting blood glucose levels, white blood cells (WBC), C-reactive protein (CRP), pH, lactate levels, hospitalization, and diagnosis in the Pediatric Emergency Department. The development of diabetes in the follow-up was determined by insulin, C-peptide, and HbA1c levels. A p-value below 0.05 was considered significant in all analyses.
Results: SH was observed in 818 patients who applied to the emergency department in the last five years. The median age of patients was 22 months (1-214 months). Age of 51.2% of the patients was between 1-23 months.57.2% of the patients were male, and 42.9% were female. The male/female ratio in the study was 1.3/1. The most common diagnoses of patients with SH in the emergency department were lower respiratory tract infection (59.5%), tonsillitis (11.1%), and acute gastroenteritis (10.5%), respectively. The median blood glucose level of the patients was 232 mg/dl (201-438 mg/dl). The blood glucose level of 9.3% of the patients was above 300 mg/dl. 15.7% of patients with SH were hospitalized. HbA1c level was lower than 5.5% in all patients who had an HbA1c test during their follow-up (n=45). Patients who received salbutamol (p=0.013) or corticosteroids (p=0.004) had higher blood glucose levels, and those who received fluid therapy (p=0.001) had lower blood glucose levels in the emergency department. Blood glucose levels were similar in hospitalized and non-hospitalized patients (233 mg/dl vs 227 mg/dl, p=0.536). In ROC analysis, CRP (p<0.001), WBC (p<0.001), age (p<0.001), diagnosis in the emergency department (p=0.019) were predictive for hospitalization, however, blood glucose level (p=0.548) was not.
Conclusion: SH is a common finding among children evaluated in the Pediatric Emergency Department. Our findings regarding children with SH do not indicate an increased risk of diabetes.

Keywords

Children , Diabetes , Stress Hyperglycemia

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