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Pathophysiology of critical illness hyperglycemia in children

  • Bülent Hacıhamdioğlu EMAIL logo , Tanıl Kendirli , Gönül Öçal , Zeynep Şıklar , Şenay Savaş Erdeve , Erdal İnce and Merih Berberoğlu
Published/Copyright: May 3, 2013
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 26 Issue 7-8

Abstract

Causes of hyperglycemia in critically ill non-diabetic children may differ from those in adults. The objective of this study was to investigate the pathogenesis of critical illness hyperglycemia (CIH) in terms of insulin resistance and β-cell dysfunction. Critically ill children with blood glucose (BG) levels of >150 mg/dL (8.3 mmol/L) were enrolled in the study. Insulin sensitivity and β-cell function in the hyperglycemic and euglycemic periods were analyzed with BG/insulin and BG/C-peptide ratios, and utilizing homeostasis model assessment (HOMA). A total of 40 patients were enrolled in the study. BG/insulin and BG/C-peptide ratios were significantly higher in the hyperglycemic period. The HOMA-B and S scores for the hyperglycemic period revealed that out of all the patients who survived (n=30), 20 had β-cell dysfunction, while the remaining (n=11) had insulin resistance. β-cell dysfunction was significantly higher in the hyperglycemic period (p<0.001). As in adults, β-cell dysfunction may play a major role in the pathophysiology of CIH in children.

Keywords: β-cell dysfunction; children; critical illness hyperglycemia; pathophysiology
Corresponding author: Bülent Hacıhamdioğlu, MD, Department of Pediatric Endocrinology, Ankara University Faculty of Medicine, Ankara, Turkey, Phone: +90 03125956791, Fax: +90 0312 3191440

Conflict of interest statement

The authors declare that they have no competing interests.

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Received: 2012-10-7
Accepted: 2013-3-24
Published Online: 2013-05-03
Published in Print: 2013-08-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpem-2012-0313
Keywords for this article
β-cell dysfunction; children; critical illness hyperglycemia; pathophysiology

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  1. Masthead
  2. Masthead
  3. Editorials
  4. Editorial
  5. Precocious puberty and diagnostic tests
  6. Review article
  7. The influence of carbohydrate quality on cardiovascular disease, the metabolic syndrome, type 2 diabetes, and obesity – an overview
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  10. Umbilical cord and fifth-day serum vaspin concentrations in small-, appropriate-, and large-for-gestational age neonates
  11. Growth patterns in pubertal HIV-infected adolescents and their correlation with cytokines, IGF-1, IGFBP-1, and IGFBP-3
  12. Estrogen receptor α gene analysis in girls with central precocious puberty
  13. Trends of body composition among adolescents according to maturation stage and body mass index
  14. Oxidized low-density lipoprotein levels and carotid intima-media thickness as markers of early atherosclerosis in prepubertal obese children
  15. Interaction of bone mineral density, adipokines and hormones in obese adolescents girls submitted in an interdisciplinary therapy
  16. The contribution of art therapy in poorly controlled youth with type 1 diabetes mellitus
  17. NOX, the main regulator in oxidative stress in experimental models of phenylketonuria?
  18. Changes in growth pattern, leptin ghrelin and neuropeptide Y levels after adenotonsillectomy in prepubertal children
  19. Impact of inborn errors of metabolism on admission in a neonatal intensive care unit: a 4-year report
  20. Correlation between bone mineral density measured by peripheral and central dual energy X-ray absorptiometry in healthy Indian children and adolescents aged 10–18 years
  21. Thyroid-stimulating hormone (TSH) level in nutritionally obese children and metabolic co-morbidity
  22. Hepatocyte growth factor as an indicator of neonatal maturity
  23. Pathophysiology of critical illness hyperglycemia in children
  24. The influence of exposure to maternal diabetes in utero on the rate of decline in β-cell function among youth with diabetes
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  26. Abdominal aorta intima media thickness in obese children
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  31. Variable phenotype in five patients with Wolcott-Rallison syndrome due to the same EIF2AK3 (c.1259delA) mutation
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