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An Overview of Hypoglycemia in Children Including a Comprehensive Practical Diagnostic Flowchart for Clinical Use

Alberto Casertano1, Alessandro Rossi2,3, Simona Fecarotta2

  • 1Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy.

Frontiers in Endocrinology
|August 19, 2021
PubMed

Insights

Hypoglycemia, a common neonatal and childhood emergency resulting from impaired glucose homeostasis, lacks standardized definitions and diagnostic approaches. This review clarifies age-related definitions and proposes a diagnostic flowchart to prevent neurological complications.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Hypoglycemia results from impaired glucose homeostasis due to metabolic, endocrine, or congenital disorders.
  • It is a frequent emergency in neonatal and pediatric populations.
  • Current diagnostic and management guidelines lack consensus.

Purpose of the Study:

  • To present age-related definitions of hypoglycemia in neonates and children.
  • To provide an overview of causes, management, and diagnostic-therapeutic approaches.
  • To propose a diagnostic flowchart for prompt intervention.

Main Methods:

  • Literature review of current definitions and diagnostic work-up.
  • Synthesis of information on etiological causes and management strategies.
  • Development of a comprehensive diagnostic flowchart.

Main Results:

  • No universal consensus exists on hypoglycemia definition and diagnosis.
  • Key etiological factors include metabolic, endocrine, and congenital disorders.
  • A structured approach is crucial for preventing brain injury.

Conclusions:

  • Standardized definitions and diagnostic approaches are needed for pediatric hypoglycemia.
  • Prompt diagnosis and management are essential to avoid long-term neurological sequelae.
  • The proposed flowchart facilitates systematic evaluation and treatment.

Keywords:
childhood hypoglycemiacongenital hyperinsulinismendocrine hypoglycemiaglucose homeostasisinborn errors of metabolismneonatal hypoglycemia

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