Question:
From Ontario, Canada:
My niece's son age 9 has been diagnosed with Ketotic Hypoglycemia. We are not finding much about this disease. Would you have any information about this or where we could find some information on this disease? Thank you.
Answer:
The term 'ketotic hypoglycemia' was very much in vogue some twenty
years ago until it was realised that the great majority of children who
were thus described had uncertain appetites that led to symptomatic
hypoglycemia and an associated ketosis that reflected the
normal metabolism of body fat rather than glucose as a source of energy. For
the most part, then, it should not be regarded as a disease and it can be
treated by
dietary measures to sustain blood glucose levels and sometimes it may
be very helpful to talk to an experienced children's nutritionist to solve
this problem.
The reason you have not been able to find much information is that
the term is less used nowadays. It is nonetheless useful for a number
of reasons. First of all, hypoglycemia without ketosis in younger children
would suggest the possibility of a defect in fatty acid oxidation.
Secondly, using the phrase gives an opportunity to pause short of more
elaborate and costly investigations to explain the symptoms and to see if
they respond to simple measures as they nearly always do. It is
extremely unlikely in a nine year old; but in a very few instances ketotic
hypoglycemia represents an inborn error of organic acid or carbohydrate
metabolism, conditions that require special facilities and expertise to
diagnose and treat.
DO'B
Original posting 12 Aug 97
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