Hypoglycemia in hypopituitary children.
Fifty-two children with growth hormone (GH) deficiency were examined for factors that might influence development of hypoglycemia. Symptomatic and asymptomatic hypoglycemia occurred with equal frequency in children with isolated GH and multiple anterior pituitary deficiencies. Of 52 children, nine (17%) had symptomatic hypoglycemia and 14 (27%) had asymptomatic hypoglycemia. Symptomatic hypoglycemia was more frequent in children who were both young (less than 4 years of age) and lean (elevated height age/weight age [HA/WA] ratio). With HGH therapy, these children had decreases in HA/WA ratios and improvement in carbohydrate homeostasis. Insulin responses to oral glucose and intravenous arginine administration were substantially lowered in children with symptomatic hypoglycemia, A deficiency of gluconeogenic substrate or impairment of amino acid mobilization may be a factor in the development of hypoglycemia in hypopituitarism similar to that postulated for  ketotic hypoglycemia.
D000293:Adolescent; D000304:Adrenal Cortex Function Tests; D000324:Adrenocorticotropic Hormone / Q000172:deficiency; D000367:Age Factors; D001835:Body Weight; D050260:Carbohydrate Metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005951:Glucose Tolerance Test; D013006:Growth Hormone / Q000172:deficiency; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology*; D007018:Hypopituitarism / Q000175:diagnosis / Q000378:metabolism*; D007223:Infant; D008297:Male; D013960:Thyroid Function Tests
D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone