Hyperglycaemia in Children

Introduction

Hyperglycaemia is a state of high blood glucose level. A random blood glucose of > 8.0 mmol/1 is hyperglycaemic.
Preterm infants particularly when treated with 10% dextrose infusion or total parenteral nutrition are prone to it.
Hypothermia, sepsis, post-operative cases, neonatal diabetes (transient or persistent) are also associated.

Clinical features

  • Persistent dehydration with glycosuria.
  • Transient diabetes is suspected among infants with wasting or intra-uterine growth restriction who develop hyperglycaemia
    whilst on enteral feeds.

Management

  • The concentration of dextrose in infusion should be reduced.
  • Insulin 0.05-0.1 iu/kg/hour should be commenced if RBG remains above 10 mmol/l with glycosuria despite reduction of glucose concentration in infusion.
  • Treat the identified cause if possible.