Skip to main content

Hyperglycemia in Children Hospitalized with Acute Asthma

  • Chapter
  • First Online:
Progress in Medical Research

Abstract

Hyperglycemia is frequently observed in adults with acute asthma. We aimed to assess the frequency of hyperglycemia and its relation to outcomes in children admitted with acute asthma. In this retrospective study, we reviewed medical records of non-diabetic 166 children (66 girls) with the mean age of 5.4 ± 2.6 years (range of 2–12 years), who were hospitalized with acute asthma between January 2012 through December 2014. Data pertaining to demographics, vital signs, oxygen saturation, serum blood glucose level, electrolytes, blood gases, and admission were collected. Children with other chronic conditions were excluded. The findings were that hyperglycemia (blood glucose ≥ 11.1 mmol/l) was observed in 38.6% of children. The median baseline blood glucose (IQR) was 9.8 mmol/l (7.2–13.3 mmol/l). Blood glucose level was associated with the length of hospitalization, with a median extension of 1.8 days, but was inversely associated with the serum potassium and bicarbonate levels. There were no associations between baseline blood glucose and age, gender, baseline respiratory rate, oxygen saturation, or intensive care admission. Hyperglycemia resolved spontaneously in all affected children. We conclude that hyperglycemia is common in children hospitalized with acute asthma. Hyperglycemia could be considered as a marker of a longer hospital stay.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agus MS, Steil GM, Wypij D, Costello JM, Laussen PC, Langer M, Alexander JL, Scoppettuolo LA, Pigula FA, Charpie JR, Ohye RG, Gaies MG, SPECS Study Investigators (2012) Tight glycemic control versus standard care after pediatric cardiac surgery. N Engl J Med 367(13):1208–1219

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Alberts WM, Williams JH, Ramsdell JW (1986) Metabolic acidosis as a presenting feature in acute asthma. Ann Allergy 57(2):107–109

    PubMed  CAS  Google Scholar 

  • American Diabetes Association (2003) Expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 26(Suppl 1):S5–20

    Google Scholar 

  • Branco RG, Tasker RC (2007) Glycemic level in mechanically ventilated children with bronchiolitis. Pediatr Crit Care Med 8(6):546–550

    Article  PubMed  Google Scholar 

  • Branco RG, Garcia PC, Piva JP, Casartelli CH, Seibel V, Tasker RC (2005) Glucose level and risk of mortality in pediatric septic shock. Pediatr Crit Care Med 6(4):470–472

    Article  PubMed  Google Scholar 

  • Chawla S, Seth D, Cortez J (2007) Asthma and hyperglycemia. Patient report. Clin Pediatr 46(5):454–455

    Article  Google Scholar 

  • Cochius-den Otter SC, Joosten KF, de Jongste JC, Hop WC, de Hoog M, Buysse CM (2015) Insulin therapy in hyperglycemic children with severe acute asthma. J Asthma 52(7):681–686

    Article  CAS  PubMed  Google Scholar 

  • Dawson KP, Penna AC, Manglick P (1995) Acute asthma, salbutamol and hyperglycaemia. Acta Paediatr 84(3):305–307

    Article  CAS  PubMed  Google Scholar 

  • DeFronzo RA, Ferrannini E, Hendler R, Wahren J, Felig P (1978) Influence of hyperinsulinemia, hyperglycemia, and the route of glucose administration on splanchnic glucose exchange. Proc Natl Acad Sci U S A 75(10):5173–5177

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Don M, Valerio G, Korppi M, Canciani M (2008) Hyper- and hypoglycemia in children with community-acquired pneumonia. J Pediatr Endocrinol Metab 21(7):657–664

    Article  CAS  PubMed  Google Scholar 

  • Dresner A, Laurent D, Marcucci M, Griffin ME, Dufour S, Cline GW, Slezak LA, Andersen DK, Hundal RS, Rothman DL, Petersen KF, Shulman GI (1999) Effects of free fatty acids on glucose transport and IRS-1-associated phosphatidylinositol 3-kinase activity. J Clin Invest 103(2):253–259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dungan KM, Braithwaite SS, Preiser JC (2009) Stress hyperglycaemia. Lancet 373(9677):1798–1807

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, Quagliaro L, Ceriello A, Giugliano D (2002) Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 106(16):2067–2072

    Article  CAS  PubMed  Google Scholar 

  • Evans WE, Johnson JA (2001) Pharmacogenomics: the inherited basis for interindividual differences in drug response. Annu Rev Genomics Hum Genet 2:9–39

    Article  CAS  PubMed  Google Scholar 

  • Griesdale DE, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, Dhaliwal R, Henderson WR, Chittock DR, Finfer S, Talmor D (2009) Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ 180(8):821–827

    Article  PubMed  Google Scholar 

  • Hirshberg E, Larsen G, Van Duker H (2008) Alterations in glucose homeostasis in the pediatric intensive care unit: hyperglycemia and glucose variability are associated with increased mortality and morbidity. Pediatr Crit Care Med 9(4):361–336

    Article  PubMed  Google Scholar 

  • Koskela HO, Salonen PH, Niskanen L (2013) Hyperglycaemia during exacerbations of asthma and chronic obstructive pulmonary disease. Clin Respir J 7(4):382–389

    Article  CAS  PubMed  Google Scholar 

  • Ling PR, Smith RJ, Bistrian BR (2005) Hyperglycemia enhances the cytokine production and oxidative responses to a low but not high dose of endotoxin in rats. Crit Care Med 33(5):1084–1089

    Article  CAS  PubMed  Google Scholar 

  • Macrae D, Grieve R, Allen E, Sadique Z, Morris K, Pappachan J, Parslow R, Tasker RC, Elbourne D, CHiP Investigators (2014) A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med 370(2):107–118

    Article  CAS  PubMed  Google Scholar 

  • Majahan P, Kamat D (2007) Asthma and hyperglycemia. Diagnosis: acute asthma exacerbation worsened by hyperglycemia. Clin Pediatr (Phila) 46(5):455–457

    Google Scholar 

  • Masoli M, Fabian D, Holt S, Beasley R (2004) The global burden of asthma: executive summary of the GINA dissemination committee report. Allergy 59(5):469–478

    Article  PubMed  Google Scholar 

  • Meert KL, Clark J, Sarnaik AP (2007) Metabolic acidosis as an underlying mechanism of respiratory distress in children with severe acute asthma. Pediatr Crit Care Med 8(6):519–523

    Article  PubMed  Google Scholar 

  • Meert KL, McCaulley L, Sarnaik AP (2012) Mechanism of lactic acidosis in children with acute severe asthma. Pediatr Crit Care Med 13(1):28–31

    Article  PubMed  Google Scholar 

  • Nogrady SG, Hartley JP, Seaton A (1977) Metabolic effects of intravenous salbutamol in the course of acute severe asthma. Thorax 32(5):559–562

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schacke H, Docke WD, Asadullah K (2002) Mechanisms involved in the side effects of glucocorticoids. Pharmacol Ther 96(1):23–43

    Article  CAS  PubMed  Google Scholar 

  • Shires R, Joffe BI, Heding LG, Seftel HC (1979) Metabolic studies in acute asthma before and after treatment. Br J Dis Chest 73(1):66–70

    Article  CAS  PubMed  Google Scholar 

  • Smith AP, Banks J, Buchanan K, Cheong B, Gunawardena KA (1992) Mechanisms of abnormal glucose metabolism during the treatment of acute severe asthma. Q J Med 82(297):71–80

    PubMed  CAS  Google Scholar 

  • Taylor MR (2007) Pharmacogenetics of the human beta-adrenergic receptors. Pharmacogenomics J 7(1):29–37

    Article  CAS  PubMed  Google Scholar 

  • Tenney SM (1956) Sympatho-adrenal stimulation by carbon dioxide and the inhibitory effect of carbonic acid on epinephrine response. Am J Phys 187(2):341–346

    CAS  Google Scholar 

  • Tickner TR, Cramp DG, Foo AY, Johnson AJ, Bateman SM, Pidgeon J, Spiro SG, Clarke SW, Wills MR (1977) Metabolic response to intravenous salbutamol therapy in acute asthma. Thorax 32(2):182–184

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R (2006) Intensive insulin therapy in the medical ICU. N Engl J Med 354(5):449–461

    Article  PubMed  Google Scholar 

  • Vlasselaers D, Milants I, Desmet L, Wouters PJ, Vanhorebeek I, van den Heuvel I, Mesotten D, Casaer MP, Meyfroidt G, Ingels C, Muller J, Van Cromphaut S, Schetz M, Van den Berghe G (2009) Intensive insulin therapy for patients in paediatric intensive care: a prospective, randomised controlled study. Lancet 373(9663):547–556

    Article  CAS  PubMed  Google Scholar 

  • Wiener RS, Wiener DC, Larson RJ (2008) Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA 300(8):933–944

    Article  CAS  PubMed  Google Scholar 

  • Wytrychowski K, Obojski A, Hans-Wytrychowska A (2016) The influence of insulin therapy on the course of acute exacerbation of bronchial asthma. Adv Exp Med Biol 884:45–51

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors extend their appreciation to the Deanship of Scientific Research at King Saud University for funding this work through the research grant No. RGP-190.

Conflicts of Interest

The authors declare that they have no conflict of interest in relation to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abdullah A. Alangari .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mobaireek, K.F. et al. (2018). Hyperglycemia in Children Hospitalized with Acute Asthma. In: Pokorski, M. (eds) Progress in Medical Research. Advances in Experimental Medicine and Biology(), vol 1070. Springer, Cham. https://doi.org/10.1007/5584_2018_152

Download citation

Publish with us

Policies and ethics