Neonatal Causes

1. Gestational diabetes. These infants, often LGA, are hyperin-sulinemic at birth and can become hypoglycemic when the placental glucose source is removed.

2. IUGR or SGA. These infants can have limited glycogen stores and decreased body fat and muscle protein.

3. Perinatal stress. Stressors such as fetal hypoxia and prematurity can lead to hypoglycemia.

4. Genetic malformations. Patients with Beckwith-Wiedemann syndrome may exhibit hypoglycemia.

D. Ketotic Hypoglycemia. This is the most common form of childhood hypoglycemia and is related to prolonged fast, usually with intercurrent illness. Typical presentation is a child, aged 18 months to 5 years, who has missed dinner or breakfast and is found to be difficult to arouse. Can be associated with seizures and lead to coma.

E. Sepsis. Hypoglycemia or hyperglycemia can occur in septic shock. Usually a sign of late infection.

F. Severe Liver Failure. Glycogen stores are easily depleted in patients with advanced liver disease and destruction.

G. Reactive Hypoglycemia. Can occur post-prandially in a small percentage of the population, especially in patients with dumping syndrome.

H. Endocrinopathies. Includes adrenal insufficiency, hypothyroidism, and hypopituitarism.

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