Hyperglycemia is a medical condition characterized by increase in blood sugar level. A person is said to be hyperglycemic when the blood glucose level is above 250mg/dL. Hyperglycemia in infants is a serious issue and should be dealt with carefully by an experienced pediatrician or endocrinologist. This article discusses about hyperglycemia in infants, if it is a hereditary disorder, how one can diagnose it and about its treatment.
Hyperglycemia In Infants
Hyperglycemia in children is often caused because of excessive food intake, inadequate insulin dosage, less activity than usual, presence of other medical issues or stress. Hyperglycemia is caused when there is increase in glucose level in the body. Glucose is nothing but sugar that is derived from the food that the child consumes. Glucose is stored in the body and is used by the body cells as the main source of energy. However, it is important to note that, excess glucose in the body can cause harm to the body and should be treated immediately. Increased glucose level in blood is the hallmark of diabetes, hence hyperglycemia in infants needs to be attended. If not treated, excess glucose in the blood can damage the blood vessels and it can also increase the risk for developing heart issues, kidney issues, stroke, eye problems, nerve issues etc. These issues usually don’t occur in childhood; however, if left uncontrolled they can succeed into diabetes of adulthood followed by complications mentioned earlier.
Is Hyperglycemia in Infants a Hereditary Disorder?
Hyperglycemia in infants is very rare and may be associated with neonatal diabetes mellitus. The frequency of neonatal diabetes is about 1 out of 400000 to 1 out 600000 live births. It is commonly asked if hyperglycemia in infants is a hereditary disorder? In order to understand this, there is a need for further research into the role of genetics in hyperglycemia and diabetes. Hyperglycemia in infants and children may be caused from genetic inheritance, but other factors too play an important role.1 The permanent form of neonatal diabetes can be traced to genetic mutations.
Apart from genetic causes, the three main factors that contribute to increased glucose level in children are:
- Food intake
- Physical activities
- Regular intake of diabetes medicine such as insulin (If prescribed).
It is important to maintain a balance between these three factors to maintain normal blood glucose levels. Any disruption in this balance can shoot off the sugar level. Other factors that can contribute to increased blood glucose level are listed below:
- Not getting enough dosage of diabetes medicine (or insulin)
- Poor meal plan
- Not coping up excess eating with adequate medication dosage
- Inadequate exercising or sedentary lifestyle
- Presence of other underlying medical issues
- Side effects of certain medications such as steroids (which may be used to treat other conditions such as inflammation)
- Using expired insulin pump or other insulin administration issues.
How is Hyperglycemia in Infants Diagnosed?
Diagnosis of hyperglycemia in infants is done by an experienced pediatric endocrinologist. Diagnosis involves obtaining a detailed case history followed by physical examination of the child. The signs and symptoms elicited by the child often help to diagnose hyperglycemia in infants but laboratory investigations help to confirm the same.
Hyperglycemic newborns may have difficulty with weight gain, frequent episodes of dehydration and history of restricted intrauterine growth. Other symptoms to watch out for include:
Frequent Urination. The kidneys often react to increased glucose level in the body by increased urination. The child affected by this issue will urinate frequently with increased volumes of urine.
Increased Thirst as a Sign to Diagnose Hyperglycemia in Infants. Children with hyperglycemia often suffer from dehydration. This along with increased urination often increases thirst is children.
Increased Hunger with Weight Loss. Children with hyperglycemia often have increased appetite. However, there is also increased drop in body weight of the child. With increased level of glucose in the body, the body does not have enough insulin to break down the glucose. This may cause break down of muscles and stored fat in an attempt to fuel up the hungry cells. This results in weight loss.
Lack of Energy. The child may experience fatigue and generalized tiredness. This is because the body is unable to use the glucose for proper energy production.
Diagnosis of elevated blood glucose level often requires a special blood test called as the HbA1c test. It may be also required to regularly check the blood glucose level in children (sometimes even multiple times a day) using a blood glucose meter. This is important as sometimes the child may have elevated blood glucose level without any classic symptoms.
What is the Treatment of Hyperglycemia in Infants?
Treatment of hyperglycemia in infants involves identification of the cause of the condition and correcting it. In most of the cases, the care givers provide advices specific to the child based on his or her condition.
Some of the common suggestions for management of blood sugar level to treat hyperglycemia in infants include:
- Ensuring that the child gets adequate insulin of the right dosage and at the right time.
- Ensure that the insulin is not expired or the pump is not defective
- Plan a diet chart for the child with help of an experienced nutritionist
- Adjust insulin dosage if the child overeats or under eats
- Ensure that the child is physically active and exercises regularly
Check blood glucose level regularly and contact the care giver in case of any abnormal value. A single abnormal reading may not be alarming, as it is common with most diabetic patients. However, consistent abnormal value should be addressed as early as possible.
Treatment of hyperglycemia in infants also depends on whether there is diabetic ketoacidosis present at the time of diagnosis. In such cases, immediate medical care is needed and hospitalization in intensive care is advisable.2
Hyperglycemia in infants should be considered a serious condition as it can make the child prone to a number of serious health conditions. As soon as hyperglycemia is diagnosed in infants, it must be taken care of exactly as per the doctor’s advice.