CHAPTER 3 – Hypoglycemia

Publisher Summary This chapter discusses definition, incidence, clinical manifestations, and pathogenesis of hypoglycemia, followed by a clinical classification of hypoglycemic syndromes, emphasizing their unique characteristics related to the age of onset. At any age, hypoglycemia may or may not be associated with symptoms or clinical manifestations. In an earlier study, adults, organic hyperinsulinism, reactive or functional hyperinsulinism, and hepatic causes of low blood glucose accounted for over 80% of the patients with spontaneous symptomatic hypoglycemia. The neonate with hypoglycemia may have episodes of tremors, apnea, cyanosis, irregular respirations, limpness, twitching, a high pitched or weak cry, refusal to feed, eye rolling, coma, and convulsions. Persistent or chronic hypoglycemia may produce such bizzare manifestations as to be completely misleading. Hypoglycemia is not a disease but represents a defect in the complex physiological mechanisms that maintain normoglycemia.