Frequency of Hypoglycemia During Insulin Tolerance Test in Children with Suspected Growth Hormone Deficiency

Abstract

OBJECTIVE:To determine the frequency of hypoglycemia during insulin tolerance test in children with suspected growth hormone deficiency. Material and Methods: A total of 62 short stature children suspected of growth hormone deficiency were enrolled from department of pediatric medicine, Nishtar Hospital, Multan using non-probability consecutive sampling technique. Total duration was 1 year from May 2016 to May 2017. These children underwent insulin tolerance test and were examined for the development of hypoglycemia at different time intervals. All the data were recorded on the proforma. Data were entered and analyzed using SPSS-18. Results: Of these 62 study cases, 36 (58.1%) were boys and 26 (41.9%) were girls. Mean age of our study cases was 8.94 + 2.81 (Minimum age was 4 years while maximum age was 13 years) and majority of study cases i.e. 37 (59.7%) belonged to age group of 4 – 9 years of age. Mean height of our study cases was 107. 81 + 12.67 centimeters (Minimum height 80 cm while maximum height was 130 cm), majority of study cases i.e. 53 (85.5%) of our study cases had height in the range of 80 – 120 cm. Mean weight of the study cases was 17.00 + 5.66 kilograms (Minimum weight was 6 Kg while maximum weight was 35 Kg), majority of our study cases i.e. 51 (82.3%) were having weight in the range of 6-20 Kg. Mean values for baseline blood glucose level were 92.27 + 10.99 mg/dl (Minimum baseline blood glucose level was 55 mg/dl while maximum value was 111 mg/dl). Mean first blood glucose level after 30 minutes of administration of Insulin was 46.56 + 14.07 mg/dl, after 45 minutes was 47.26 + 9.45 mg/dl, after 60 minutes was 61.35 + 17.63 mg/dl, after 90 minutes was 69.44 + 16.17 mg/dl, after 120 minutes was 79.65 + 12.18 mg/dl. Hypoglycemia was seen in 49 (79%) of our study cases (Table-6). Growth hormone deficiency was observed in 39 (62.90%), 23 (37.10 %) were normal cases. Conclusion: Insulin tolerance test (ITT) is safe and reliable test, if being performed in compliance with standard protocols under appropriate supervision of trained healthcare professionals for proper monitoring of side effects. The test should only be performed in the centers having well trained and qualified staff and proper equipment to treat any possible side effect.

Keywords:Hypoglycemia, Growth hormone deficiency, Short stature.