1 / 23

Hypoglycemia in the infant and childh

Hypoglycemia in the infant and childh. It is a medical emergency demanding immediate investigation and treatment. Definition of Hypoglycemia Plasma glucose value of less than 50mg/dl(2.8 MMOL/Lit) Lower limit acceptable during therapy for Hypoglycemia is 70 mg/dl(the goal of

chessa
Download Presentation

Hypoglycemia in the infant and childh

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hypoglycemia in the infant and childh

  2. It is a medical emergency demanding immediate investigation and treatment

  3. Definition of Hypoglycemia • Plasma glucose value of less than 50mg/dl(2.8 MMOL/Lit) • Lower limit acceptable during therapy for Hypoglycemia is 70 mg/dl(the goal of Therapy is to maintain plasma glucose levels in the normal range of 70-100 mg/dl most of time )

  4. Symptoms and signs • Adrenergic manifestation • Nevro glycopenic manifestation

  5. Adrenergic manifestation • Sweating • Shakiness • Tachycardia • Anxiety • Weakness • Hanger • Naseua-vometing

  6. Nevroglycopenia manifestation • Headache • Visual disturbances • Lethargy • Mental confusion • Convulsion • Hypothermia

  7. Major causes of Hypo glicemia in the infant and childh

  8. Hyper insulinism • Aut.R(newborn period) • AUT.D(infancy and childhood) • With hyperammonia (infancy and childhood) • Glucokinax activation(aut.D) • SCHAD(loss of function mutation) • Exercise • Factitious • Insulinoma • Auto immune

  9. Criteria for diagnosing Hyper insulinism based on critical sample • Detectable insulin (>2MIU/ML) • Low FFA(<1.5 MMOL/LIT) • Low ketons of plaama(<2.0 MMOL/ML) • Glgcemic response to 1mg intravenous glucagon at the time of fasting Hypoglycemia(≥30mg/dl glucose rising in 20 min)

  10. Ketotic Hypoglycemia • The most common form of childhood Hypoglycemia • Begins between 18 months to 5 years and spontaneous remits by the age of 8-9 years • Low plasma alanine level • Decrease glucose production during over night fasting • Low insulin level-keton body elevated • High level of counter regulatory hormones • Most patients are smaller than age-match control and have a history of transient neonatal Hypoglycemia

  11. Hormone deficiency • GH deficiency due to panhypopitutrism • ACTH deficiency due to panhypopitutrism

  12. Metabolic disease • GSD disorder • Galactosemia • Organic acidemia • Gluconeogenesis defect • ß oxidation defect • Fructose intolerance

  13. Systemic disease • Sepsis • Head injury • Acute hepatic failure • Multiple organe failure • cyanotic congenital heart disease • CHF • CRF • Diarrhea • Malaria

  14. Drugs • Ethanol • Beta blocker • Acetaminophen • Salicylate • Sulfanamid • Quinine • Co-TMX • Pentamidine

  15. Alimentary Hypoglycemia(late dumping) • In patient with nissen fundoplication and gastrostomy tube replacement • Hypoglycemia & hyperinsulinism 1-2 hours after feeding • Treatment consist of acarbose-cachanel blocker octerotide-complex carbohydrate formula

  16. Treatment Drug • diazoxide • D/W 15% 2-4 cc/kg state fallow by 6-8 mg/ng/min عوارض • پرموئی • تهوع • هیپراورسیمی • افزایش سن استخوانی • افت فشار • کاهش I9G

  17. octerotide هر 6-12 ساعت 20 U /kg /day عوارض: • ترشح • تهوع – استفراغ • اسهال • هپاتیت • سنگ کیسه صفرا • درد محل تزریق surgery

More Related