title: Quantifying the risk of hypoglycaemia in children undergoing the glucagon stimulation test.
abstract: OBJECTIVE
  The low-dose (15-30 μg/kg) glucagon stimulation test (GST) is assumed to be associated with fewer episodes of low blood glucose (BG). We aimed to quantify the risk of hypoglycaemia in children undergoing the low-dose GST to evaluate their growth hormone status.
  
  
  METHODS
  Blood glucose fluctuations during the GST in 80 children (median age 8·7 years, 45 boys, 66 prepubertal) who received a median 20·5 μg/kg of intramuscular glucagon were reviewed.
  
  
  METHODS
  The rate of (i) hypoglycaemia (BG < 3·3 mm), (ii) falling BG trend at the end of the GST (lower BG at 180 min than at 120 min), (iii) hypoglycaemia and falling BG trend at the end of the GST, and (iv) at-risk patients (those with at least one of the three risks measures).
  
  
  RESULTS
  Twenty-seven of the 80 children had hypoglycaemia during the GST. Twenty-six children showed a falling BG trend at the end of the GST and were significantly younger than the other 54 children with a rising BG trend [5·1 (3·1-10·4) years vs 9·6 (5·4-11·8) years, P = 0·02]. Eight children had both a falling BG trend and hypoglycaemia at end of the test. Forty-four children were at-risk patients, and the odds ratio of being an at-risk patient in those <8 years old was 2·63 (95% CI 1·06-6·57, P = 0·04).
  
  
  CONCLUSIONS
  Hypoglycaemia is not uncommon during the low-dose GST. Young children, especially those <8 years old, are particularly at risk. BG monitoring should be considered essential from a safety perspective.
authors: Endocrinology Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
authors: Song Hai
authors: SH
authors: Lim
authors: Rashida
authors: R
authors: Vasanwala
authors: Ngee
authors: N
authors: Lek
authors: Fabian
authors: F
authors: Yap