Prevalence of hyperglycaemia in paediatric patients on systemic corticosteroid therapy at the Kenyatta National Hospital

Abstract

Introduction The natural glucocorticoids are steroid molecules produced and released by the adrenal cortex. Synthetic glucocorticoids are widely used in the clinical setting for their' immunosuppressive and anti-inflammatory effects. In spite of their useful effects they have been shown to have detrimental effects. Hyperglycaemia is one of them and the interest of this study. Steroid induced hyperglycaemia is associated with significant morbidity and mortality in the adult population but there is little data available in the paediatrics age group. Objectives The primary objective was to determine the prevalence of hyperglycaemia in patients aged eighteen years and below on systemic corticosteroid at the Kenyatta National Hospital. Secondary objective was to determine the associated factors associated with development of steroid induced hyperglycaemia. This was a hospital based cross-sectional study. Methods: Once recruited, a researcher developed questionnaire was administered. Height, weight were measured. Two blood samples were collected; a fasting blood sugar and a 2 hour post prandial blood sugar (after an oral glucose load) and thereafter analysed in the laboratory. Results Ninety six participants were enrolled into the study. Sixty (62.5%) were male and 36(37.5%) were female. Median age was 8 years. Majority of participants; 85 (88.5%) were on prednisolone for their current treatment. The overall prevalence of hyperglycaemia was 61.5%. The dose per kilogram body weight was found to significantly associated with hyperglycaemia. Conclusions There is a high prevalence of hyperglycaemia in patients on glucocorticoid treatment. There's therefore need to monitor blood sugar of all patients on glucocorticoid therapy.