Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;16(1):81-87.
doi: 10.1177/1932296820959315. Epub 2020 Oct 7.

The Effect of Various, Everyday Practices on Glucose Levels in Critically Ill Children

Eleni Tsotridou  1 , Eirini Kotzapanagiotou  2 , Asimina Violaki  2 , Meropi Dimitriadou  1 , Menelaos Svirkos  2 , Peristera-Eleni Mantzafleri  2 , Vasiliki Papadopoulou  2 , Maria Sdougka  2 , Athanasios Christoforidis  1
Affiliations

The Effect of Various, Everyday Practices on Glucose Levels in Critically Ill Children

Eleni Tsotridou et al. J Diabetes Sci Technol. 2022 Jan.

Abstract

Background: To evaluate the effect of various, everyday intensive care unit (ICU) practices on glucose levels in critically ill pediatric patients with the use of a continuous glucose monitoring system.

Methods: Seventeen sensors were placed in 16 pediatric patients (8 male). All therapeutic and diagnostic interventions were recorded and 15 minutes later, a flash glucose measurement was obtained by swiping the sensor with a reader. Glucose difference was calculated as the glucose value 15 minutes after the intervention minus the mean daily glucose value for each individual patient. Additionally, the consciousness status of the patient (awake or sedated) was recorded.

Results: Two hundred and five painful skin interventions were recorded. The mean difference of glucose values was higher by 1.84 ± 14.76 mg/dL (95% CI: -0.19 to 3.87 mg/dL, P = .076). However, when patients were categorized regarding their consciousness level, mean glucose difference was significantly higher in awake state than in sedated patients (4.76 ± 28.07 vs -2.21 ± 15.77 mg/dL, P < .001). Six hundred forty-nine interventions involving the respiratory system were recorded. Glucose difference during washings proved to be significantly higher than the ones during simple suctions (4.74 ± 14.18 mg/dL vs 0.32 ± 18.22 mg/dL, P = .016). Finally, glucose difference in awake patients was higher by 3.66 ± 13.91 mg/dL compared to glucose difference of -2.25 ± 21.07 mg/dL obtained during respiratory intervention in sedated patients.

Conclusions: Diagnostic and therapeutic procedures in the ICU, especially when performed in an awake state, exacerbate the stress and lead to a significant rise in glucose levels.

Keywords: children; continuous glucose monitoring; flash glucose monitoring; hyperglycemia; intensive care unit; stress.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Increased glucose levels associated to an intracerebral hemorrhage and clinical deterioration. (b) Increased glucose levels after extubation and patient awakening.
Figure 2.
Figure 2.
Mean glucose values in sedated and awake state in 11 patients with alteration in level of consciousness during the study period. Mean glucose levels of all patients were lower during sedation with a difference that was approaching significance.
Figure 3.
Figure 3.
Mean difference of glucose values during painful intervention minus mean daily glucose levels of each individual were significantly lower when subjects were sedated than when subjects were awake.
Figure 4.
Figure 4.
Mean difference of glucose values during respiratory interventions minus mean daily glucose levels of each individual were significantly higher during suctions than simple washings.
Figure 5.
Figure 5.
Mean difference of glucose values during respiratory interventions minus mean daily glucose levels of each individual were significantly higher when subjects were awake than when subjects were sedated.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Srinivasan V. Stress hyperglycemia in pediatric critical illness: the intensive care unit adds to the stress! J Diabetes Sci Technol. 2012;6(1):37-47. - PMC - PubMed
    1. Clark L, Preissig C, Rigby MR, Bowyer F. Endocrine issues in the pediatric intensive care unit. Pediatr Clin North Am. 2008;55(3):805-833. - PubMed
    1. Faustino EV, Apkon M. Persistent hyperglycemia in critically ill children. J Pediatr. 2005;146(1):30-34. - PubMed
    1. Wintergerst KA, Buckingham B, Gandrud L, Wong BJ, Kache S, Wilson DM. Association of hypoglycemia, hyperglycemia, and glucose variability with morbidity and death in the pediatric intensive care unit. Pediatrics. 2006;118(1):173-179. - PubMed
    1. Yung M, Wilkins B, Norton L, Slater A. Glucose control, organ failure, and mortality in pediatric intensive care. Pediatr Crit Care Med. 2008;9(2):147-152. - PubMed