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The 2-deoxyglucose test as a supplement to fasting for detection of childhood hypoglycemia
Insights
The 2-deoxyglucose (2DG) test effectively screens for childhood hypoglycemia, complementing prolonged fasting tests. This safe, short test aids in detecting low blood sugar when used alongside fasting.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
Background:
- Childhood hypoglycemia requires reliable screening methods.
- Prolonged fasting tests are effective but time-consuming.
- The 2-deoxyglucose (2DG) test offers a potential shorter alternative.
Purpose of the Study:
- To compare the acute response to 2-deoxyglucose (2DG) with prolonged fasting for detecting childhood hypoglycemia.
- To evaluate the diagnostic accuracy of both tests, individually and in combination.
Main Methods:
- Assessed plasma glucose response in 10 reference children and 23 children with suspected hypoglycemia.
- Administered a 2-deoxyglucose (2DG) infusion (50 mg/kg IV over 30 min).
- Compared 2DG test results with prolonged fasting test outcomes (28-36 hours).
Main Results:
- The 2DG test showed a plasma glucose increase of 19-56 mg/dl within 60-120 min.
- Children with confirmed hypoglycemia had low fasting glucose (<30 mg/dl) and poor 2DG response.
- No documented hypoglycemia cases were missed by either test; the combination proved complementary.
Conclusions:
- The 2-deoxyglucose (2DG) test is a safe, effective supplement to prolonged fasting for childhood hypoglycemia screening.
- Neither test alone is fully reliable, but their combined use enhances detection accuracy.
- The 2DG test provides a shorter, equally effective alternative or adjunct to prolonged fasting.
Abstract:
The acute response to simulated hypoglycemia induced by 2-deoxyglucose (2DG) was compared with the prolonged fasting test as a possible screening test for detection of childhood hypoglycemia. Ten children, ages 2-9 yr, without a documented history of hypoglycemia were classified retrospectively as reference subjects. While fasting, their plasma glucose decreased to an average of 50 mg/dl (range, 30-74) between 28-36 h. After infusion of 2DG, 50 mg/kg IV over 30 min, their plasma glucose increased by an average of 35 mg/dl (range, 19-56) between 60-120 min. The half-life of plasma 2DG was 48 min. Twenty-three other children in the same age range had an abnormal response to one or both of these tests. Thirteen of these children became definitely hypoglycemic while fasting (glucose less than 30 mg/dl) and also failed to increase their plasma glucose by more than 10 mg/dl after 2DG. Five children had plasma glucose values between 30-40 mg/dl during the first 24 h of fasting that were associated with a change in mental status but responded to 2DG with an increase in plasma glucose. The remaining five subjects had an apparently normal response to fasting but did not respond to 2DG; two of these had documented spontaneous hypoglycemia. No cases of documented hypoglycemia were undetected by either test. It is concluded that the 2DG test is a short safe supplement to fasting which is equally effective as the prolonged fasting test in detecting hypoglycemia. Neither test alone is completely reliable, but the combination is complementary.