Hypoglycemia in Infants and Children

摘要: Hypoglycemia is an important problem in infants and children. It can cause seizures, coma, permanent brain damage, death. Several metabolic systems are activated during fasting to prevent hypoglycemia. Thus, hypoglycemia be viewed as a failure of one these or abnormality the hormones that controls systems. This review supplements ‘‘Hypoglycemia Newborns Infants’’ by Dekelbab Sperling [1], which appeared earlier volume this series. The previous article discussed signs symptoms its effect on central nervous system. also etiology, evaluation, management hypoglycemia, with particular focus neonatal hyperinsulinism. expands upon discussing other causes children context abnormal adaptation fasting. FASTING ADAPTATION body stores energy form glycogen, triglycerides, protein liver, fat, muscle. During fasting, several convert into fuels tissues use (Fig. 1). Glycogenolysis converts glycogen liver glucose. Lipolysis triglycerides fat fatty acids glycerol. Proteolysis muscle amino acids. Gluconeogenesis glycerol gluconeogenic glucose liver. Fatty undergo oxidation produce acetyl coenzyme A (acetyl-CoA). Acetyl-CoA undergoes ketogenesis ketones, such b-hydroxybutyrate.