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Neural dysfunction during hypoglycaemia
T H Koh1, A Aynsley-Green, M Tarbit
1Department of Child Health, University of Newcastle upon Tyne.
Insights
Hypoglycemia (low blood sugar) can affect children even without symptoms. Maintaining blood glucose above 2.6 mmol/l is crucial for normal neural function in pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Neurophysiology
Background:
- Controversy exists regarding the definition and significance of hypoglycemia in children, particularly asymptomatic cases.
- Assessing the impact of low blood glucose on neural function in pediatric populations is critical.
Purpose of the Study:
- To investigate the relationship between blood glucose concentration and neural function in children.
- To determine the critical blood glucose threshold for maintaining normal neural function in pediatric patients.
Main Methods:
- Measured sensory evoked potentials in relation to blood glucose levels in 17 children.
- Included children undergoing fasting or insulin administration for metabolic investigations and those with spontaneous hypoglycemia.
- Monitored blood glucose concentrations and correlated them with evoked potential abnormalities.
Main Results:
- Abnormal evoked potentials were observed in 10 out of 11 children with blood glucose below 2.6 mmol/l.
- Five of these children with abnormal evoked potentials were asymptomatic.
- No evoked potential changes were noted in children with blood glucose levels above 2.6 mmol/l.
Conclusions:
- Blood glucose levels below 2.6 mmol/l are associated with abnormal neural function in children, even in the absence of clinical symptoms.
- Maintaining blood glucose above 2.6 mmol/l is recommended to ensure normal neural function in children.
- This threshold is important for defining and managing hypoglycemia in pediatric care.
Abstract:
There is controversy over the definition of hypoglycaemia in neonates and children and over its significance when 'asymptomatic'. We measured sensory evoked potentials in relation to blood glucose concentration in 17 children: 13 were fasted or given insulin to investigate endocrine or metabolic abnormalities and four had spontaneous episodes of hypoglycaemia. Abnormal evoked potentials were recorded in 10 of the 11 children whose blood glucose concentration fell below 2.6 mmol/l; five of these 10 children were 'asymptomatic'. No change in evoked potentials was recorded in the six children whose blood glucose concentration remained above 2.6 mmol/l. Our findings suggest that the blood glucose concentration should be maintained above 2.6 mmol/l to ensure normal neural function in children irrespective of the presence or absence of abnormal clinical signs.