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Licensed Unlicensed Requires Authentication Published by De Gruyter June 29, 2013

Adaptation of glucose metabolism to fasting in young children with infectious diseases: a perspective

  • Wilco C.W.R. Zijlmans EMAIL logo , Anne A.M.W. van Kempen , Mireille J. Serlie , Piet A. Kager and Hans P. Sauerwein


Hypoglycemia is a frequently encountered complication in young children with infectious diseases and may result in permanent neurological damage or even death. Mortality rate in young children under 5 years of age is increased four- to six-fold when severe infectious disease is complicated by hypoglycemia. Young age, prolonged fasting and severity of disease are considered important risk factors. This perspective describes the combined results of recently conducted studies on the effect of these risk factors on glucose metabolism in children with different infectious diseases. The results of these studies have nutritional implications for the approach in clinical practice towards young children with infectious diseases and specific recommendations are made. A unique finding is the existence of infectious disease-related differences in the adaptation of glucose metabolism during fasting in young children.

Corresponding author: Wilco C.W.R. Zijlmans, Pediatric Research Institute, Suriname Children’s Hospital/Academic Hospital Paramaribo, Paramaribo, Suriname, Phone: +597 8600200, E-mail:

Contribution of the authors:

WCWRZ carried out the studies and data analyses and drafted the manuscript. AAMWvK participated in the design of the studies and coordination and helped with statistical analysis and to draft the manuscript. MJS and PAK participated in the design of the studies and helped to draft the manuscript. HPS conceived of the studies, participated in its design and coordination, and helped to draft the manuscript. All authors read and approved the final manuscript.

We thank Michael W.T. Tanck of the Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, The Netherlands, for his excellent support on statistical analyses.

Conflict of interest statement

Conflict of interest: None of the authors has any conflict of interest.

Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.


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Received: 2013-5-3
Accepted: 2013-5-16
Published Online: 2013-06-29
Published in Print: 2014-01-01

©2014 by Walter de Gruyter Berlin Boston

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