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2005) Glut-1 deficiency syndrome: clinical, genetic and therapuetic aspects. C. (2006) Hepatic glycogen synthase deficiency: an infrequently recognised cause of ketotic hypoglycemia. : (2001) High incidence of unrecognized metabolic and endocrinologic disorders in acutely ill children with previously unrecognized hypoglycemia. , Aurbach - Klipper Y. (1998) Standard and Low-Dose Short Adrenocorticotropin Test Compared with Insulin-Induced Hypoglycemia for Assessment of the Hypothalamic-Pituitary-Adrenal Axis in Children with Idiopathic Multiple Pituitary Hormone Deficiencies.

Clinical features of hypoglycemia Glucose usually provides the primary source for brain energy. Clinical manifestations are broad and can be from a combination of adrenergic stimulation or from decreased availability of glucose for the CNS. Unlike older children, infants are not able to verbalize their symptoms and are particularly vulnerable to hypoglycemia (Cranmer, 2009). Symptoms of hypoglycemia occur through two main clinical pathways. , 2004). , 2004). , 2004). During the first or second day of life, symptoms vary from asymptomatic to CNS and cardiopulmonary disturbances (Guideline, 2004).

After surgery, rapid absorbtion of high-glucose fluids causes Management Approach to Hypoglycemia 21 hyperinsulinism, responsible for hypoglycemia in 1-2 hours later. This condition, known as a late (glucose) dumping may occur in one third of patients with fundoplication and gastric tube. In long-term management, an avoidance high load of rapid carbohydrates, a supplementation of acarbose of 12-75 mg per dose, and a complex carbohydrate formula may be successful (Ng et al, 2002). 8 Hypoglycemia induced by exogenous agents Many medicaments may cause hypoglycemia as a side effect, directly or indirectly.