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Hypoglycemia, Pediatric

Katherine Lord, MD and Diva D. De León, MD, MSCE Reviewed 10/2018
 


BASICS

DESCRIPTION

Hypoglycemia can be defined as a plasma glucose concentration low enough to impair brain function. Evaluation should be undertaken in infants and young children with documented plasm...

DIAGNOSIS

HISTORY

  • Symptoms of hypoglycemia in the infant and young child:

    • Poor feeding

    • Lethargy

    • Irritability

    • Tremors

    • Seizure

  • Older children and adolescents demonstrate Whipple triad:

    • Autonomic and neuroglycop...

TREATMENT

GENERAL MEASURES

  • Major goal is prevention of brain damage.

  • IV dextrose infusions should be given to stabilize plasma glucose acutely.

    • For an acute hypoglycemic event, give a bolus of 2 to 3 mL/...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Up to 30–48% of HI and 20% of GSD patients can have neurodevelopmental abnormalities due to hypoglycemia.

  • Patients who undergo near total pancreatectomy are at ver...

ADDITIONAL READING

  • Ferrara C, Patel P, Becker S, et al. Biomarkers of insulin for the diagnosis of hyperinsulinemic hypoglycemia in infants and children. J Pediatr.  2016;168:212–219. [View Abstr...

CODES

ICD9

251.1 Other specified hypoglycemia 

ICD10

E16.1 Other hypoglycemia 

SNOMED

83469008 Hyperinsulinism (disorder) 

FAQ

  • Q: How low can glucose go and for how long before brain damage occurs?

  • A: The definition of hypoglycemia has been the subject of controversy in pediatrics, but activation of glucose counterregulato...

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