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December 24, 2007

Hypoglycemia

Question from Johnstone, United Kingdom:

My son was rushed to hospital about a week ago as he vomited then I couldn't wake him up. Once there, the doctors discovered his blood glucose was 0.8 mmol/L [14.4 mg/dl] and his Glasgow Coma Scale was 5. I wasn't really given a diagnosis, but told it was probably because he hadn't been eating well or had a virus, neither of which were the case. He was given intravenous dextrose then discharged with a follow-up appointment next month. On the letter to our general practitioner, the diagnosis is given as ketotic hypoglycaemia. Is this likely to recur and is there anything we can do to prevent it? Are there any questions I should ask the paediatrician at the clinic? I'm so scared it will happen again as he was absolutely fine prior to this happening.

Answer:

Ketotic hypoglycemia is not a rare condition. Fortunately, most children outgrow it. Some kids seem to run out of fuel and become hypoglycemic. In doing so, they make lots of ketones from fat. You should have ketone sticks or a meter that measures blood betahydroxybuterate at home. For a while, you should check ketones at bedtime and in the morning. If he seems to be having them, he should be fed. The hypoglycemia may seem to occur on days when he eats less. Holidays are classic as well as sick days. If you can prevent the ketones or clear them up with food, you will avoid the hypoglycemic reactions.

LD