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Journal of Tropical Pediatrics Advance Access published online on November 23, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp109
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Mini-review: Management of Hypoglycaemia in Children Aged 0–59 Months

Robin Achokia, Newton Opiyoa and Mike Englisha,b

aKEMRI/Wellcome Trust Research Programme, Nairobi, Kenya
bDepartment of Paediatrics, University of Oxford, Oxford, UK

Correspondence: Newton Opiyo, KEMRI/Wellcome Trust Research Programme, PO Box 43640, 00100 GPO, Nairobi, Kenya. Tel.: +254 20 2715160; Fax: +254 20 2717673; E-mail: nopiyo{at}nairobi.kemri-wellcome.org.


  Abstract

Hypoglycaemia is associated with poor prognosis in many severe childhood illnesses especially in sub-Saharan Africa where the prevalence of malaria, diarrhoea and malnutrition remains high. Uncertainty, however, still persists regarding the significance, definition and management of childhood hypoglycaemia. As a step towards defining optimal, evidence-based diagnostic and management criteria, we (i) reviewed the evidence underlying current recommendations for the management of hypoglycaemia, and (ii) analysed a large set of data on blood glucose levels and associated outcomes of paediatric admissions in a rural hospital over an 11-year period. Current definitions and treatment protocols for hypoglycaemia are based on observational data and expert opinion. Future large pragmatic randomized trials would help define optimal treatment thresholds. Emerging evidence suggests that sublingual sugar is a feasible and effective therapy for correction of hypoglycaemia, and should be considered where intravenous glucose is delayed or impossible.

Key Words: hypoglycaemia • glucose • dextrose • newborn • children


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