Hypoglycemia in Children: Major Endocrine-Metabolic Causes and Novel Therapeutic Perspectives

Abstract

Hypoglycemia is due to defects in the metabolic systems involved in the transition from the fed to the fasting state or in the hormone control of these systems. In children, hypoglycemia is considered a metabolic-endocrine emergency, because it may lead to brain injury, permanent neurological sequelae and, in rare cases, death. Symptoms are nonspecific, particularly in infants and young children. Diagnosis is based on laboratory investigations during a hypoglycemic event, but it may also require biochemical tests between episodes, dynamic endocrine tests and molecular genetics. This narrative review presents the age-related definitions of hypoglycemia, its pathophysiology and main causes, and discusses the current diagnostic and modern therapeutic approaches.

Telemedicine in Improving Glycemic Control Among Children and Adolescents With Type 1 Diabetes Mellitus: Systematic Review and Meta-Analysis

“…Although HbA 1c is the gold standard for long-term glycemic control, the use of HbA 1c alone to assess glycemic management in children can be misleading due to the magnitude of blood glucose fluctuations [ 64 ], and the pursuit of HbA 1c compliance can be accompanied by an increase in the frequency of hypoglycemia [ 65 , 66 ]. Hypoglycemia in children is a metabolic-endocrine emergency due to the potential for brain injury; permanent neurological sequelae; and, in rare cases, death [ 67 ]. Therefore, when assessing glycemic control in children, special attention should be paid to the incidence of hypoglycemia.…”