Prognosis of imparied glucose tolerance in children with stress hyperglycemia, symptoms of hypoglycemia, or asymptomatic glucosuria.

Thirty-seven children and youths were ascertained because of stress hyperglycemia (3), asymptomatic glucosuria (21), or symptoms suggestive of hypoglycemia (13); 17 of them met the National Diabetes Data Group criteria for impaired glucose tolerance. Three ascertained because of glucosuria developed symptomatic insulin-dependent diabetes over the subsequent 14 months. They had more severe hyperglycemia and/or deficient insulin responses compared to those with normal tests or those with IGT who did not develop IDD. Insulin responses relative to glycemia were significantly age related and did not differ between the normal and IGT groups (excluding the three who developed IDD). The two-hour oral glucose tolerance test may be of value in young persons who have had stress hyperglycemia or asymptomatic glucosuria to rule out abnormality in a standardized manner or to detect preclinical IDD. Patients with autonomic symptoms may have transitory IGT as a concomitant manifestation of life stress; glucose tolerance testing of them appears unwarranted in the absence of other compelling symptoms or a family history of IDD.