Recognition, assessment and management of hypoglycaemia in childhood

Hypoglycaemia is frequent in children and prompt management is required to prevent brain injury. In this article we will consider hypoglycaemia in children after the neonatal period. The most common causes are diabetes mellitus and idiopathic ketotic hypoglycaemia (IKH) but a number of endocrine dis...

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Bibliographic Details
Published in:Archives of disease in childhood 2016-06, Vol.101 (6), p.575-580
Main Authors: Ghosh, Arunabha, Banerjee, Indraneel, Morris, Andrew A M
Format: Article
Language:English
Subjects:
Biochemical tests
Blood Glucose - metabolism
Brain
Childhood
Clinical Laboratory Techniques
Diabetes
Diagnosis, Differential
Early Diagnosis
Emergency Treatment
Fatty Acids - metabolism
Fuels
Genetics
Glucose - therapeutic use
Glycogen - biosynthesis
Glycogen - metabolism
Homeostasis - physiology
Humans
Hyperinsulinism - complications
Hyperinsulinism - drug therapy
Hypoglycemia
Hypoglycemia - diagnosis
Hypoglycemia - drug therapy
Hypoglycemia - etiology
Infection - complications
Ketone Bodies - metabolism
Liver Failure - complications
Medical History Taking - methods
Neonates
Patients
Physical Examination - methods
Young Children
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Summary:Hypoglycaemia is frequent in children and prompt management is required to prevent brain injury. In this article we will consider hypoglycaemia in children after the neonatal period. The most common causes are diabetes mellitus and idiopathic ketotic hypoglycaemia (IKH) but a number of endocrine disorders and inborn errors of metabolism (IEMs) need to be excluded. Elucidation of the diagnosis relies primarily on investigations during a hypoglycaemic episode but may also involve biochemical tests between episodes, dynamic endocrine tests and molecular genetics. Specific treatment such as cortisol replacement and pancreatic surgery may be required for endocrine causes of hypoglycaemia, such as adrenal insufficiency and congenital hyperinsulinism. In contrast, in IKH and most IEMs, hypoglycaemia is prevented by limiting the duration of fasting and maintaining a high glucose intake during illnesses.
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2015-308337