Diagnosis and Management of Pediatric Hypoglycemia

Posted by e-Medical PPT Sunday, October 10, 2010
Hypoglycemia is the most common metabolic problem in neonates. In children, a blood glucose value of less than 40 mg/dL (2.2 mmol/L) represents hypoglycemia.Patients with hypoglycemia may be asymptomatic or may present with severe CNS and cardiopulmonary disturbances. The most common clinical manifestations can include altered level of consciousness, seizure, vomiting, unresponsiveness, and lethargy. Any acutely ill child should be evaluated for hypoglycemia, especially when history reveals diminished oral intake.Sustained or repetitive hypoglycemia in infants and children has a major impact on normal brain development and function.
Hyperinsulinism, or persistent hyperinsulinemic hypoglycemia of infancy (PHHI), is the most common cause of hypoglycemia in the first 3 months of life. It is well recognized in infants of mothers with diabetes. Other causes in all ages include gram-negative sepsis; endotoxin shock; and ingestions, including salicylates, alcohol, hypoglycemic agents, and beta-adrenergic blocking agents.Postprandial hypoglycemia is rare in children in the absence of prior GI surgery.

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