What is the morbidity associated with pediatric hypoglycemia?

Updated: Feb 19, 2018
  • Author: Robert P Hoffman, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

Hypoglycemia has both acute and long-term consequences (see Clinical). Infants and children with asymptomatic hypoglycemia have been shown to have neurocognitive defects at the time of hypoglycemia, including impaired auditory and sensory-evoked responses and impaired test performance. Many etiologies of hypoglycemia may have the same consequences, complicating the causal distinction.

Long-term consequences of hypoglycemia include decreased head size, lowered intelligence quotient (IQ), and specific regional brain abnormalities revealed by MRI. As many as 50% of patients who survive hyperinsulinemic hypoglycemia of infancy have long-term neurologic complications; this rate has changed little since the end of the 20th century. This emphasizes the need for early recognition and treatment of these children.

A study by Mahajan et al indicated that mean motor development and mental development quotients at corrected ages 6 and 12 months tend to be lower in neonates with symptomatic or asymptomatic hypoglycemia than in neonates with euglycemia. Moreover, these quotients were found to be lower in symptomatic infants than in asymptomatic ones. [12]

However, a study by Goode et al indicated that neurodevelopmental outcomes in preterm infants with neonatal hypoglycemia do not significantly differ from those of preterm infants who are euglycemic. The study, which compared preterm infants with hypoglycemia with controls at ages 3, 8, and 18 years, found no significant differences in cognitive or academic skills at any age. In addition, no clinically meaningful difference in problem behaviors was found. [13]


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