Stress hyperglycemia in febrile children: relationship to prediabetes

Minerva Endocrinol. 2011 Jun;36(2):99-105.


Aim: The aim of this study was to describe clinical characteristics and short-term outcomes in febrile infants and children with stress hyperglycemia (SH), and to evaluate the relationship between SH and prediabetes.

Methods: Febrile infants and children, with an axillary temperature ≥37.3 °C, who presented to the emergency department, were enrolled. Demographica data, illness severity, results of diagnostic tests were recorded. The patients were screened for hyperglycemia, defined as capillary blood sugar >7.7 mmol/L, using a bedside glucometer and hyperglycemia was confirmed by venous blood glucose measurements in the laboratory. Patients were classified according to illness severity, using the Emergency Severity Index (ESI). Patients with SH were also evaluated for biochemical markers to screen for pre-diabetes. Oral glucose tolerance test and immunological markers for diabetes mellitus were studied in patients with confirmed SH, one week after the emergency department visit.

Results: A hundred and eighty-five children (61% males), with a mean age of 4.46±4.08 years, were enrolled. Normoglycemic children (N.=163) constituted group 1, and children with SH (N.=22) constituted group 2. Children with high illness severity, male gender, sepsis and central nervous system (CNS) infection were more likely to have SH. All children with SH had uneventful recovery, glucose metabolism and biochemical markers were normal and 50% were referred to the hospital.

Conclusion: SH occurred more frequently in children with higher illness severity, a body temperature >39 °C, and sepsis or CNS infection. There was no evidence of abnormal glucose metabolism or elevated biochemical markers for diabetes on follow-up, following the resolution of acute illness.

MeSH terms

  • Adolescent
  • Blood Cell Count
  • Blood Chemical Analysis
  • Blood Glucose / metabolism
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / metabolism
  • Female
  • Fever / blood*
  • Humans
  • Hyperglycemia / blood*
  • Infant
  • Infant, Newborn
  • Male
  • Prediabetic State / blood*
  • Stress, Physiological / physiology*
  • Treatment Outcome


  • Blood Glucose