What is ketogenic hypoglycemia? What are the signs and symptoms? What is the treatment?

Briefly, children have ongoing fuel needs, basically met by carbohydrate stores. Some children have fewer stores, specifically the “light” children (small for age). These children are subject to fuel shortage, which is evidenced by hypoglycemia and ketosis (a product of fat breakdown).

Such children typically present with hypoglycemia in the early morning after a day when intake was poor, such as holidays when parents are not attentive to food intake. The child plays and doesn’t eat. Treatment is food and checking the urine for ketones, which is a sign of too little food intake. I instruct parents to check the urine at bedtime, and if ketones are present, to feed and awaken in the night and feed again.

This disorder is unrelated to diabetes.

LD