Hypoglycemia is a common problem with an increasing incidence in critically ill or extremely
low birthweight infants.[1] Its potential association with
brain damage and
neurodevelopment delay make it an important topic.[1] If not due to maternal
hyperglycemia, in most cases it is multifactorial, transient and easily supported. In a minority of cases, hypoglycemia turns out to be due to significant hyperinsulinism, hypopituitarism or an inborn error of metabolism and presents more of a management challenge.[1][2]
Single episodes of hypoglycemia may occur due to
gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism.[citation needed] A list of common causes:
Prolonged fasting
Diarrheal illness in young children, especially
rotavirus gastroenteritis
By far, the most common cause of severe hypoglycemia in this age range is insulin injected for
type 1 diabetes. Circumstances should provide clues fairly quickly for the new diseases causing severe hypoglycemia. All of the congenital metabolic defects, congenital forms of hyperinsulinism, and congenital hypopituitarism are likely to have already been diagnosed or are unlikely to start causing new hypoglycemia at this age. Body mass is large enough to make starvation hypoglycemia and idiopathic ketotic hypoglycemia quite uncommon. Recurrent mild hypoglycemia may fit a
reactive hypoglycemia pattern, but this is also the peak age for
idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to
orthostatic hypotension or
hyperventilation as often as demonstrable hypoglycemia.[citation needed]
The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes, rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults.[citation needed]
Hypoglycemia is a common problem with an increasing incidence in critically ill or extremely
low birthweight infants.[1] Its potential association with
brain damage and
neurodevelopment delay make it an important topic.[1] If not due to maternal
hyperglycemia, in most cases it is multifactorial, transient and easily supported. In a minority of cases, hypoglycemia turns out to be due to significant hyperinsulinism, hypopituitarism or an inborn error of metabolism and presents more of a management challenge.[1][2]
Single episodes of hypoglycemia may occur due to
gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism.[citation needed] A list of common causes:
Prolonged fasting
Diarrheal illness in young children, especially
rotavirus gastroenteritis
By far, the most common cause of severe hypoglycemia in this age range is insulin injected for
type 1 diabetes. Circumstances should provide clues fairly quickly for the new diseases causing severe hypoglycemia. All of the congenital metabolic defects, congenital forms of hyperinsulinism, and congenital hypopituitarism are likely to have already been diagnosed or are unlikely to start causing new hypoglycemia at this age. Body mass is large enough to make starvation hypoglycemia and idiopathic ketotic hypoglycemia quite uncommon. Recurrent mild hypoglycemia may fit a
reactive hypoglycemia pattern, but this is also the peak age for
idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to
orthostatic hypotension or
hyperventilation as often as demonstrable hypoglycemia.[citation needed]
The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes, rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults.[citation needed]