From Mt. Horeb, Wisconsin, USA:
My daughter as a newborn had a hypoglycemic seizure and stopped breathing for a few seconds. We sought help from a pediatric endocrinologist and he said that this would be something that she would outgrow. Then, a year later her blood sugar dropped to 20 and she was rushed to the hospital. They have now diagnosed her with Ketotic Hypoglycemia and want to run a test that would have her fast and let her blood sugar go down. Is this really necessary and what are the symptoms (if any) that I should look for to make sure that this doesn't happen again? Also, will this be something that she will outgrow or have for the rest of her life?
Ketotic hypoglycemia is a diagnosis of exclusion. It usually does not present in the newborn period, but occurs most commonly between 18 months and 5 years of age. Briefly, children with this "disorder" are basically healthy with no hormonal deficiencies or abnormalities of sugar metabolism. When "stressed" with illness or fasting, they exhaust their stores of sugar in the liver and can develop symptomatic low blood sugars with seizures. Ketones are present in the urine indicating that their hormones are working to try and mobilize stored sugar from the liver.
Other hormonal deficiencies and errors of metabolism can present with low blood sugar and ketones in the urine. The diagnostic tests to perform would depend on results of preliminary studies. A controlled fast to reproduce the symptoms of low blood sugar may be indicated. I assume your child will be observed so that the proper blood studies are obtained when the blood sugar is low and intravenous glucose is administered if necessary.
Original posting 18 Jul 1998
Posted to Hypoglycemia
Last Updated: Tuesday April 06, 2010 15:08:57
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