11. Hypoglycemia

Summary

This chapter elucidates hypoglycemia, which carries serious short- and long-term consequences from incorrect management. Maintenance of a normal blood glucose concentration is critical to brain development and function so hypoglycemia is a medical emergency. The best time to make the diagnosis is by taking the correct blood and urine samples at the point of crisis. Delay in management may precipitate complications but intervention without the diagnostic samples delays the diagnosis until either another similar event takes place or hypoglycemia can be reproduced during a planned elective fasting study. The most practical course is to take samples at the first opportunity and institute treatment without delay. The risk of harm as a result of hypoglycemia is greater in infants and children because brain size is relatively greater to body size than later in life. Glucose is the prime source of energy for the brain but ketones can provide an alternative source in chronic hypoglycemia.