Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children

• Published in: Journal of Pediatric Endocrinology & Metabolism Vol. 36; no. 9; pp. 851 - 858
• Main Authors: Avnon Ziv, Carmit, Banon, Tamar, Ben Tov, Amir, Chodick, Gabriel, Gabay, Linoy, Auerbach, Adi, Hirsch, Harry J., Levy Khademi, Floris
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 26.09.2023; Walter de Gruyter GmbH
• Subjects: Age; Body mass index; children; female; Glucose; Glucose monitoring; Health services; Health surveillance; male; puberty; sugar; glucose; puberty; female; children; sugar; male
• ISSN: 0334-018X; 2191-0251
• DOI: 10.1515/jpem-2023-0099

Understanding the normal range of laboratory values as pertained to different age groups and males or females is paramount in health care delivery. We aimed to assess the distribution of morning fasting serum glucose levels by age and sex in the general population of children using a large-scale population-based cohort. A retrospective study with real-world de-identified data from a large, state mandated health fund in Israel among children aged 2-18 years old between 2006 and 2019. Age, sex, and BMI differences in mean glucose levels were evaluated. Study included 130,170 venous blood samples from 117,411 children, 53.3 % were female. After adjusting for age boys had higher fasting serum glucose levels than girls, with a mean of 89.21 ± 8.66 mg/dL vs. 87.59 ± 8.35 (p<0.001) [4.95 ± 0.48 mmol/L vs. 4.86 ± 0.46]. Compared to the 15 to 18 year-olds (88.49 ± 7.63 mg/dL) [4.92 ± 0.42 mmol/L], 2 to 5 year-olds had lower glucose levels (84.19 ± 10.65, [4.68 ± 0.59] (p<0.001)), 11 to 14 year-olds had higher glucose (90.40 ± 7.42 [5.02 ± 0.41], (p<0.001)) and 6 to 10 year-olds showed no difference (88.45 ± 8.25) [4.91 ± 0.46]. 33.0 % (n=42,991) had a BMI percentile record the same year as their glucose test result. There was a weak yet significant positive association between blood glucose levels and BMI. Our large cohort indicates that boys have slightly higher fasting serum glucose levels than girls, as do adolescents compared to younger children. This finding is important for the delivery of adequate health care, screening for illness and avoiding unnecessary investigations and tests.