Idiopathic ketotic hypoglycemia (IKH) is the most common cause of hypoglycemia in the pediatric population aged 19 months to five years. It is a physiologic process characterized by an unusual degree of episodic hypoglycemia after a brief caloric deprivation period. Children generally present with an intercurrent illness such as upper respiratory tract infection in the morning hours after fasting of around 10 hours. Associated symptoms are weakness, palpitations, tremor, nausea, sweating, headache, anxiety, and personality changes.
Hypoglycemia in infants and children is not defined exactly, but a plasma glucose level < 35-45 mg/dL in neonates and < 55 mg/dL in children defines hypoglycemia. Determining whether the patient has ketotic or nonketotic hypoglycemia is a good starting point for evaluating hypoglycemia. The symptoms of hypoglycemia can be divided into two categories:…
