HYPOGLYCEMIA AND METABOLIC EMERGENCIES

Question 1

Definition

Answer 1

<2.8 mmol / L

Question 2

DDx: Hypoglycemia in neonates

Answer 2

Diabetic Mother
Hypoglycemia inducing drug in mother
Maternal eclampsia
Congenital Heart Disease
Infection / Sepsis
Adrenal Hemorrhage
Hypothermia
Fetal alcohol syndrome
Hypopituitarism

Question 3

DDx: Hypoglycemia in Infancy and Childhood

Answer 3

Idiopathic ketotic hypoglycemia / starvation

Low levels of hyperglycemic hormones (cortisol, GH…)

Diabetes

Infection / Sepsis

Inborn Errors of Metabolism

Hypothermia

Drug induced
Hyperinsulinism

Idiopathic

Question 4

Management

Answer 4

5 cc / kg D10 W - neonate

2 cc / kg D25 W - infant

1 cc / kg D50 W - child

D10 infusion at 1.5 maintenance

Glucagon 0.03 mg / kg IM / SC (max 0.5 mg)

if adrenal insufficiency is suspected 25 mg IV / IM for neonates or infants, 50 mg for toddlers and school-aged children, 100 mg for everyone else

Consider empiric antibiotics