Hypoglycemia

Question 1

Measurements?

Answer 1

In diabetic child- <72 mg/dl / 4 mmol/L

In normal child - <50 mg/dl

Question 2

Symptoms of hypoglycemia?

Answer 2

Change with age and whether other ebergy sources can be utilized or not
Stimulate SNS
Hunger, tummy ache, sweatiness,faintish,dizzy,tremors
May progress to seizure and coma

Question 3

Tx of hypoglycemia?

Answer 3

Conscious child- sugary food
Unconscious child- Iv dextrose 10% 2ml/kg bolus then infusion
If no canula, IM glucagon (0.5-1mg) and then infusion

Question 4

Causes of hypoglycemia?

Answer 4

Fasting

1. insulin excess
   - excess exogenous insulin (dm)
   - beta cell tumors
   - drug induced (sulphonylureas)
   - autoimmune (insulin receptor ab)
   - beckwith xd
2. without hyperinsulinemia
   - liver disease
   - ketotic hypoglycemia inborn errors of metabolism (glycogen storage disorders)
   - hormonal def (addiosons,congenital adrenal hyperplasia, reduced GH, reduced ACTH)

reactive/non fasting

• galactosaemia
• leucine sensitivity
• fructose intolerance
• maternal diabetes
• hormonal deficiency
• aspirin/alcohol poisoning