What is the role of fasting in the diagnosis of pediatric hypoglycemia?

Updated: Sep 12, 2019
  • Author: Robert P Hoffman, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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If the critical-sample measurements are not available at the time of initial presentation, the hypoglycemia must be reproduced. This is usually achieved using a closely monitored fast. This fast should be conducted in a center that can respond quickly and appropriately if significant hypoglycemic consequences develop. When the plasma glucose concentration falls to less than 2.5 mmol/L, the fast is stopped, and the critical sample is drawn before any treatment is given. The maximum length of the fast depends on the age of the child. Conservative recommendations for maximum lengths of fasting are as follows:

  • Younger than age 6 months - 8 hours

  • Aged 6-8 months - 12 hours

  • Aged 8-12 months - 16 hours

  • Aged 1-2 years - 18 hours

  • Aged 2-7 years - 20 hours

  • Older than age 7 years - 24 hours

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