Association of hypoglycemia, hyperglycemia, and glucose variability with morbidity and death in the pediatric intensive care unit.

Objective: We evaluated retrospectively plasma glucose levels and the degree of hypoglycemia, hyperglycemia, and glucose variability in a PICU and then assessed their association with hospital length of stay and mortality rates.

Methods: Electronic medical records at the Packard Children's Hospital at Stanford University were reviewed retrospectively for all PICU admissions between March 1, 2003, and March 31, 2004. Patients with a known diagnosis of diabetes mellitus were excluded.

Prevention of type 1a diabetes mellitus*.

Type 1 diabetes begins with the progressive autoimmune mediated destruction of the insulin-producing beta cells. When sufficient beta cell function is lost, the endocrine phase, characterized by insulin deficiency and hyperglycemia, supervenes. While a genetic predisposition to diabetes is an important precondition, most believe an environmental factor or factors serve as the trigger for initiating this process.

Endocrinology of growth and growth factors.

This review discusses normal growth patterns and the appropriate use of preprinted growth curves. The important roles of thyroid and growth hormone in the modulation of growth are delineated. I present an approach to the evaluation and proper management of children and adolescents with short stature and poor growth.