title: Recognition, assessment and management of hypoglycaemia in childhood.
abstract: Hypoglycaemia is frequent in children and prompt management is required to prevent brain injury. In this article we will consider hypoglycaemia in children after the neonatal period. The most common causes are diabetes mellitus and idiopathic ketotic hypoglycaemia (IKH) but a number of endocrine disorders and inborn errors of metabolism (IEMs) need to be excluded. Elucidation of the diagnosis relies primarily on investigations during a hypoglycaemic episode but may also involve biochemical tests between episodes, dynamic endocrine tests and molecular genetics. Specific treatment such as cortisol replacement and pancreatic surgery may be required for endocrine causes of hypoglycaemia, such as adrenal insufficiency and congenital hyperinsulinism. In contrast, in IKH and most IEMs, hypoglycaemia is prevented by limiting the duration of fasting and maintaining a high glucose intake during illnesses.
authors.affiliation: Paediatric Inherited Metabolic Disease, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester, UK.
authors.forename: Arunabha
authors.identifier: http://orcid.org/0000-0002-8202-8693
authors.initials: A
authors.lastname: Ghosh
authors.affiliation: Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Indraneel
authors.initials: I
authors.lastname: Banerjee
authors.affiliation: Paediatric Inherited Metabolic Disease, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester, UK.
authors.forename: Andrew A M
authors.initials: AAM
authors.lastname: Morris
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D019411:Clinical Laboratory Techniques; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D004638:Emergency Treatment; D005227:Fatty Acids / Q000378:metabolism; D005947:Glucose / Q000627:therapeutic use; D006003:Glycogen / Q000096:biosynthesis / Q000378:metabolism; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000188:drug therapy; D007003:Hypoglycemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D007239:Infections / Q000150:complications; D007657:Ketone Bodies / Q000378:metabolism; D017093:Liver Failure / Q000150:complications; D008487:Medical History Taking / Q000379:methods; D010808:Physical Examination / Q000379:methods
chemical_list: D001786:Blood Glucose; D005227:Fatty Acids; D007657:Ketone Bodies; D006003:Glycogen; D005947:Glucose
keywords: Endocrinology; General Paediatrics; Metabolic; Paediatric Practice