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Hypoglycemia

more about Hypoglycemia


Low blood "sugar," low blood glucose



  • One definition is a blood glucose lower than 35-40 mg. per 100 cc. of blood in the first  day of life, and lower than 45mg. per 100 cc. of blood after that (there are other definitions).
  • There is debate whether abnormally low blood glucose in an asymptomatic infant is a disease state, but it is probably safer to treat such infants rather than to just observe them.
  • Hypoglycemia can occur in all age-groups.
  • Hypoglycemia may be symptomatic or not. Severe or long-lasting hypo-glycemia does produce brain damage.  The severity of the signs and symptoms do not necessarily match the blood sugar value.

  • Common: jitteriness, irritability, pallor
  • Sweating, weakness
  • Headache, hunger, clouding of consciousness, convulsions
  • Also, there may be no symptoms

  • Most body hormones raise blood glucose; insulin lowers blood glucose.  Therefore, when insulin is present in blood at greater than normal levels, hypoglycemia can occur; and similarly, when other body hormones are decreased.
  • Poisonings (aspirin)
  • Inborn Errors of metabolism
  • Liver or pancreatic disease
  • Starvation or prolonged fasting

  • An abnormally low blood glucose establishes hypoglycemia if treatment with glucose rapidly corrects both the blood glucose level, and any symptoms.  It is necessary, beyond this diagnosis, to perform history, physical, and other laboratory tests to find the underlying cause (for example, Inborn Errors of metabolism).
  • Blood glucose is measured either by obtaining capillary blood by finger-stick/heelstick, or by obtaining venous blood.
  • Laboratory error may give a falsely low blood glucose.
  • Taking a capillary blood sample from a finger that is cold, or a heel that is cold, can give a falsely-low blood sugar.  Taking a blood sample from blood that has accidentally-clotted, can give a falsely-low blood sugar.

  • In the fetus of a diabetic mother: if the mother's blood glucose is high, mother's glucose crosses the placenta into the fetus and stimulates the fetal pancreas to make more insulin.  At birth, the separation of the infant from the placenta makes the infant of a diabetic mother have the potential for a high insulin level to cause hypoglycemia.
  • Low birth weight infants
  • See causes
  • Generally, there are 2 age groups at risk: the first 6 months of life, and the two to four year age group.  The first 3 days of life are a risk factor for the infant of a diabetic mother; premature infants; and low birth weight infants who are not premature.
  • Diabetic pediatric patients on insulin are at risk for hypoglycemia, at any age.  This also applies to adults who were juvenile diabetics.

  • Rapid correction of acute hypoglycemia (newly-happening hypoglycemia) is usually done by administering glucose intravenously (IV).  Sometimes, continued IV glucose is needed, depending on serial blood glucose measurements.
  • Glucagon (a hormone that promotes release of stored sugar from the liver) is sometimes used, when I.V. glucose or a suitable vein for IV fluids is not available.
  • In some instances, with stable patients, hypoglycemia is treated with oral feedings or with a nasogastric tube feeding.

  • Seizures, coma, brain damage, mental retardation

  • A prompt measurement of blood glucose, and treatment by a physician, are both essential.

  • Infants withdrawing from maternal street drugs
  • Diseases of the central nervous system
  • Diseases with clouding of consciousness
  • Electrolyte imbalance




more about Hypoglycemia


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