Clinical investigations from the RACP

Investigation of the child with hyperglycaemia

Darrell A Price

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Abstract

Hyperglycaemia in a child is usually an indication of the development of insulin-dependent diabetes mellitus. In a small proportion of children, however, hyperglycaemia may occur in association with a stressful acute illness or as a side effect of certain medications.

Key Points

  • Hyperglycaemia in childhood is usually an indication of the development of insulin-dependent diabetes mellitus. However, not all children with mild hyperglycaemia will progress to insulin-dependent diabetes mellitus.
  • Urinary dipstick testing for glycosuria and ketonuria provides a simple and sensitive tool for excluding diabetes in a patient with a less typical presentation. A blood glucose measurement would confirm the hyperglycaemia and enable the practitioner to make the diagnosis.
  • The majority of children who develop stress or drug-induced hyperglycaemia will have normal outcomes. However, the acute illness or medication may occasionally unmask a child who is in the ‘prediabetes’ phase of insulin-dependent diabetes mellitus.
  • All children with hyperglycaemia should receive follow up, especially those who present with hyperglycaemia in the absence of a stressful illness.

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