Can anyone share with me about Ketotic hypoglycemia. My grandson was just told he has this at age 7 all I read is they usually grow out of more around that age. He has had on and off flu symptoms where he vomit and diarrhea so they did a blood test and came back with this. My daughter was taking him out of school every couple of weeks since December because the doctor kept saying it was the flu and she finally ask for some test because she could not see him getting the flu so often. He has problems with fine motor skills can this be related. I am just hoping it is the right diagnosis any input will be good. have you heard of any children this age being diagnosed with this.


Answered by: Maria/MD Health Forum Team

Ketotic hypoglycemia commonly occurs in children below 5 years of age. Its signs and symptoms may mimic those of other problems such as digestive system disorders or visual disturbances. Because of this, ketotic hypoglycemia may be overlooked.

Hypoglycemia is a condition in which the blood sugar falls below the normal range. It may occur in young children after a period of fasting, such as limited food intake caused by anorexia or vomiting which occur with certain illnesses. Not eating for a brief period typically do not cause serious side effects in most children, however, in those who have metabolic problems, skipping a meal could cause low blood sugar readings.

The exact cause of ketotic hypoglycemia is not yet completely understood. Its symptoms are same as the usual symptoms of hypoglycemia such as intense hunger, headaches, loss or weakening of the body’s basic motor functions, changes in mental status, convulsions, and as it name implies, ketosis also occurs. Ketosis is a state in which there is an increased amount of ketones in the blood. The carbohydrates or sugars from ingested food are broken down into simpler form known as glucose which serves as the cells’ main source of fuel. When glucose is not needed by the body for energy, it is stored in the liver and muscles. The stored form is known as glycogen. Normally, the glycogen is broken down to release glucose when energy boost is needed, or when the body is not getting sugar from food. If glycogen runs out, the body compensates by getting energy from fats, and this process generates molecules known as ketones. Normally, the body is able to eliminate ketones, however, when certain enzymes are absent or damaged, the concentration of ketones in the body can build up. Increased ketones affects the blood’s acidity level, this affects the urine and may later on cause liver and kidney damage.

Hypoglycemic attacks can be prevented by avoiding prolonged fasts. Frequent snacks that contain complex carbohydrates are usually recommended. Giving snacks at bedtime is also encouraged. In children who are underweight, nutritional supplement may be recommended.

If hypoglycemic attack is suspected, it is vital to seek immediate medical attention.

I’ve read that children usually outgrow ketotic hypoglycemia, however, children who started to develop the condition after age 7 may require further evaluation in order to identify possible underlying conditions. Your grandson’s parents should consider discussing their child’s condition with a pediatric endocrinologist.

References:
http://www.ncbi.nlm.nih.gov/pubmed/12611192
Crain, E. 2002. Clinical Manual of Emergency Pediatrics. McGraw-Hill Professional; 4 edition
http://www.nhs.uk/conditions/Ketosis/Pages/Introduction.aspx

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