Ethanol ingestion and related hypoglycemia in a pediatric and adolescent emergency department population

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., greater than or equal to 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.