Paeds Hypoglycaemia

Question 1

Define

Answer 1

BGL <3.3mmol/L
Infant BGL <2.6mmol/l - at risk of acute & long term neurological sequalae.
Target > 3.5mmol/L

Question 2

Causes (All ages)

Answer 2

T1DM, Congenital heart disease, Adrenal insufficiency, Sepsis

TIMES
T- toxin
I - infection
M - metabolic disorder
E - endocrine disorder
S - starvation

Question 3

Causes (Neonates <48 hrs)

Answer 3

IUGR, premie, hypothermia, Sepsis, macrosomia, pancreatic dysfxn

Question 4

Causes (neonate - 2 years)

Answer 4

Congenital hyperinsulinism, inborn error of metabolism, GH deficiency

Question 5

Causes (Child)

Answer 5

Hypopituitarism, GH deficiency, Ketotic hypoglycaemia

Question 6

Causes (Adolescent)

Answer 6

Insulinoma, Adrenal insufficiency, eating disorder

Question 7

Ix - Critical Bloods

Answer 7

VBG, Bicarb, GH, Insulin, Cortisol, Glucagon level, C peptide, LFT, Lactate
Ketones

Question 8

Mx

Answer 8

IV 2ml/kg 10% dextrose
IM Glucagon 0.03-0.1mg/kg
Buccal - 40% Glucose/glucogel 0.5ml/kg/dose
Oral feed - 60ml/kg/day