Which physical findings are characteristic of pediatric hypoglycemia?

Updated: Sep 12, 2019
  • Author: Robert P Hoffman, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Hypoglycemic reactions are usually, but not always, accompanied by an increased heart rate with bounding pulse due to increased epinephrine secretion. Infants, if awake, may be irritable, tremulous, and cranky.

If the brain’s energy supply is severely impaired, the patient's mental status is likely to be impaired, with extreme inappropriate affect and mood, lethargy, seizure, or coma.

Large body size for age in the neonate or older child suggests hyperinsulinism, although some children with hyperinsulinism are born prematurely and are small for gestational age. Decreased subcutaneous fat suggests inadequate glucose stores. Poor linear growth may point to growth hormone deficiency, and midline facial and cranial abnormalities suggest pituitary hormone deficiencies, as does micropenis in a male. Liver size should be assessed for evidence of glycogen-storage diseases.

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