Hypoglycaemia in Children

Clinical Description

CLINICAL DESCPRIPTION

Serum glucose level less than 2.5mmol/L (3mmol/L if malnourished).

Causes

• Infection
• Drugs; insulin, metformin, glibenclamide
• Toxins
• Malnutrition
• Liver failure
• Endocrine: hyper-insulinism, growth hormone deficiency, hypothyroidism, hypopituitarism, adrenal insufficiency, Congenital Adrenal hyperplasia
• Inborn errors of metabolism

Signs and Symptoms

• Sweating, Seizures, Tachycardia, Drowsiness, Confusion, Poor concentration, Blurred vision, Irritability and Nausea

Investigations

• Serum glucose, Blood gas, Urea, electrolytes and creatinine, Serum ketones, Toxin screen
• Identify underlying cause
• 100

Pharmacological

• 5ml/kg 10% Dextrose IV if neonate give 2ml/kg or via NGT if there is no IV access.
• Follow up with regular feeds or continuous Intravenous fluid containing dextrose
• Treat underlying cause

Complications

• Seizures
• Neurocognitive impairment

Complications and Referral Criteria

• Persistent hypoglycaemia