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

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Abstract
Objective:To estimate the frequency of associated hypoglycemia in an ethanol‐ingesting pediatric and adolescent population.Methods: The study was a retrospective review of nondiabetic pediatric and adolescent patients with measurable ethanol levels (i.e., >2 mmol/L) who had an ED serum glucose level determined.Results: 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.Conclusion: 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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