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ORIGINAL ARTICLE
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Is hypoglycaemia in acute ill children presenting to emergency department investigated properly?


 Pediatric Department, Tawam Hospital, Al Ain, UAE

Correspondence Address:
Noura Al Hassani,
Tawam Hospital, PO Box 15258, Al Ain
UAE
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/HMJ.HMJ_2_18

Background: Infants and children presenting to the emergency department with hypoglycemia are a diagnostic emergency and require urgent treatment. We hypothesize that pediatric patients who present with hypoglycemia associated with other acute illnesses are not being investigated properly for the hypoglycemia etiology. Methods: The medical records of all pediatric patients with the diagnosis of hypoglycemia, blood glucose level of <3mmol/L (54mg/dl) and not known to have metabolic or endocrine illness, who presented to the emergency department at Tawam Hospital from Jan 2012 until December 2014, were retrospectively reviewed. Patient's demographic data had been collected in addition to associated diagnosis, hypoglycemic related symptoms, glucocheck, serum glucose, urine ketones, workup and management. Data were analyzed using Excel 2010. Results: Among 514 subjects reviewed, 197 were included. 52% were male and 81% were less than five years of age. The most common associated diagnosis was acute gastroenteritis (AGE), 152 (77%). 46 (23%) had associated hypoglycemic related symptoms, although nonspecific. None of the subjects had specific investigations for hypoglycemia at time of presentation. 16 (8%) were identified as high risk for having pathologic cause for hypoglycemia, however 4 (25%) referred for metabolic and/or endocrinology services. Urine was checked only in 50 (25%) subjects, 45 (90%) of them tested positive for ketones. Conclusion: Evidence based clinical practice guidelines are needed in managing children with hypoglycemia associated with acute illness who are not known to have metabolic or endocrine diseases. In addition, parent's education on proper care of children with AGE is required to prevent hypoglycemia.


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    -  Hadi S
    -  Al Hassani N
    -  Abushkhaeidem M
    -  Al Khaaldi A
    -  Khayat A
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