Ethanol Ingestion and Related Hypoglycemia in a Pediatric and Adolescent Emergency Department Population

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Abstract
To estimate the frequency of associated hypoglycemia in an ethanol-ingesting pediatric and adolescent population. The study was a retrospective review of nondiabetic pediatric and adolescent patients with measurable ethanol levels (i.e., > or = 2 mmol/L) who had an ED serum glucose level determined. Over the four-and-a-half-year study period, there were 254,234 pediatric visits. One hundred eleven had ethanol levels determined (0.044% of patients) due to suspected ingestion. Of these 111, 88 had glucose levels determined. The mean age of the 88 patients was 14 years, with a mean glucose level of 5.6 mmol/L [101 mg/dL; interquartile range (IQR) 4.7-6.3 mmol/L] and a mean ethanol level of 30 mmol/L (IQR 15-43 mmol/L). Glucose levels were < 67 mg/dL (hypoglycemia) in three of the 88 (3.4%) ethanol-positive patients; all the hypoglycemic patients had significant behavioral changes. In this large retrospective series, the number of patients for whom the clinical suspicion of ethanol ingestion was confirmed was quite small. Hypoglycemia occurred in only 3.4% of these selected patients; all had altered behavior. Pediatric patients with presentations suggesting ethanol intoxication with altered behavior should be assessed for concurrent hypoglycemia.

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