Ketotic hypoglycemia in children: What causes it?

What causes ketotic hypoglycemia?

- Brenda / No state given

Answer

Ketotic hypoglycemia is a rare but serious form of low blood sugar (hypoglycemia) that occurs in young children after a period of fasting, such as due to illness. Most children can tolerate going without food for a brief period with no serious side effects. But in children with certain inherited metabolic disorders or hormone deficiencies, skipping a meal may result in low blood sugar.

In ketotic hypoglycemia, the body doesn't have enough stored carbohydrates to correct the low blood sugar because its stores are easily depleted. As a result, the body converts fats into usable carbohydrates (gluconeogenesis) to meet energy needs. A byproduct of this process is ketones. When ketones build up in the blood, they can lead to serious problems, such as coma.

Signs and symptoms of ketotic hypoglycemia include:

• Irritability
• Sweating
• Fatigue and lethargy
• Rapid breathing
• Low blood pressure, resulting in dizziness
• Loss of consciousness
• Coma

Such signs and symptoms require emergency medical attention. Treatment of ketotic hypoglycemia may include intravenous (IV) saltwater (saline) and sugar (dextrose) solutions.

If your child is at risk of ketotic hypoglycemia, closely monitor his or her diet to make sure no meals or scheduled snacks are skipped. Recurrence is possible — typically during illness, when fasting is more common — but may be prevented with diet management. Most children "outgrow" ketotic hypoglycemia by ages 8 to 10 years.