Hypoglycemia can occur any time your child has too much insulin or too little glucose in her blood. But there are certain times when hypoglycemia is more likely - and when watching…

If mild or moderate hypoglycemia isn’t treated promptly, it can turn into severe hypoglycemia. People with severe hypoglycemia have so little sugar in their system that it affects their brain. When that happens,…

Concentration of glucose in the plasma is maintained in a relatively narrow range in most persons but requires a delicate balance between glucose production and use. Euglycemia is maintained if the rate of appearance…

Regulation of hepatic glucose production is basic to the maintenance of glucose homeostasis. Although the kidney is capable of glycogen synthesis, glycogenolysis, and gluconeogenesis, it does not contribute a great deal to net…

When any child is believed to have hypoglycemia, a low blood glucose value is quickly confirmed with a test strip. Sufficient blood always should be obtained before therapeutic intervention to confirm the…

Fasting Hypoglycemia

Management of fasting hypoglycemia requires urgent treatment, diagnosis, and long-term prevention. The short-term treatment of hypoglycemia is the oral or intravenous administration of glucose. If the patient is unable to take carbohydrate…

The diagnosis and treatment of hypoglycemia that is due to drugs, critical organ failure, or endocrine deficiency is usually straightforward. Referral of patients to an endocrinologist is warranted if they have documented…

Confirmation of Hypoglycemia

The presence of hypoglycemia is often suspected on the basis of a history compatible with neurogenic or neuroglycopenic symptoms. Although sometimes compelling, the history is more often only…

Hypoglycemia has conventionally been classified into two categories: fasting (or postabsorptive) hypoglycemia and reactive (or postprandial) hypoglycemia. However, with very rare exceptions, all patients with clinically important hypoglycemia have a disorder that causes fasting hypoglycemia.…

In a very small number of patients with organic hyperinsulinism, islet hyperplasia rather than an adenoma is present. These patients typically have documented hyperinsulinemic hypoglycemia after meals but not with…

Factitious Hypoglycemia
Factitious hypoglycemia may be difficult to document. A suspicion of self-induced hypoglycemia is supported when the patient is associated with the health professions or has access to insulin or sulfonylurea drugs taken…

A number of drugs apart from the sulfonylureas can occasionally cause hypoglycemia, especially when ingested in large amounts. These include quinine, quinidine, disopyramide, and salicylates. ACE inhibitors, when taken with antidiabetic drugs, can cause hypoglycemia…