title: From hyperinsulinaemic hypoglycaemia to ketotic hypoglycaemia: the range of glucose abnormalities in patients born with intrauterine growth retardation.
abstract: BACKGROUND
  Newborns with intrauterine growth retardation (IUGR) have multiple risk factors for developing hypoglycaemia. Hyperinsulinism, both transient and prolonged, is one of the major risk factors responsible for the hypoglycaemia observed in some newborns with IUGR. Once the child has progressed beyond the infancy period, the most common cause of hypoglycaemia is ketotic hypoglycaemia. We report our observations of ketotic hypoglycaemia in six children who were born with IUGR and developed hyperinsulinaemic hypoglycaemia (HH) that required treatment with diazoxide and chlorothiazide.
  
  
  RESULTS
  In one of these children the ketotic hypoglycaemia was found to be due to growth hormone deficiency; in the remaining five patients, however, no cause for the hypoglycaemia could be found, despite extensive investigations. These observations suggest that ketotic hypoglycaemia may be more common in children with a history of IUGR. Further studies are required to understand why some newborns with IUGR and HH have an increased risk of ketotic hypoglycaemia in childhood.
  
  
  CONCLUSIONS
  Newborns with a history of IUGR and HH have an increased risk of developing ketotic hypoglycaemia in the childhood period.
authors.affiliation: London Centre for Paediatric Endocrinology and Metabolism, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH, UK.
authors.forename: Inderpal Singh
authors.initials: IS
authors.lastname: Kochar
authors.forename: Khalid
authors.initials: K
authors.lastname: Hussain
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D044903:Congenital Hyperinsulinism / Q000150:complications*; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology*; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood*; D007329:Insulin Antagonists; D007662:Ketosis / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011296:Prenatal Diagnosis
chemical_list: D001786:Blood Glucose; D007328:Insulin; D007329:Insulin Antagonists