What causes low blood sugar in children?

There are many reasons for hypoglycemia in children. For newborns, it may be caused by insufficient sugar production mechanism, especially premature babies or children with low weight. At this time, the child's liver glycogen and muscle glycogen reserves will be insufficient, which is an important cause of hypoglycemia in children. In addition, if the child has hyperinsulinemia, it is also easy to cause such phenomenon, which has a great impact on the child's growth and development.

What causes low blood sugar in children?

1. Insufficient glycogen substrate in the neonatal period

The main reason for the high incidence of hypoglycemia in premature and low birth weight infants is that the reserves of liver glycogen and muscle glycogen are insufficient, and body fat becomes the main energy supplier. The small size of the infant, especially premature and immature infants, or the impaired placental nutrient supply and the inadequate development of the enzyme system required for gluconeogenesis are the main causes of hypoglycemia.

2. Neonatal hyperinsulinemia

Infants of diabetic mothers may have temporary hyperinsulinemia. The incidence of gestational diabetes is about 2%. Such infants have sufficient storage of glycogen, protein and fat in their bodies. Newborns of diabetic mothers have hyperinsulinemia after birth and reduced secretion of glucagon, which is different from normal newborns. At the same time, due to sympathetic nerve excitement, adrenaline in the adrenal medulla is depleted, so the production of endogenous glucose is reduced, making hypoglycemia prone to occur.

3. Hyperinsulinemia in infants and children

Hyperinsulinemia can occur at any age, and neonatal hyperinsulinemia may not be caused by diabetic mothers.

4. Lack of endocrine hormones

Cortisol and growth hormone are the main hormones that antagonize insulin and are important factors in maintaining blood sugar stability in the body. Simple growth hormone deficiency or panpituitarism, and (or) ACTH-glucocorticoid deficiency, reduce the enzyme activity and matrix production of gluconeogenesis, gluconeogenesis disorders, and hypoglycemia when fasting. Addison's disease and adrenoleukodystrophy can also cause hypoglycemia. In addition, when blood sugar decreases in people with adrenal medulla deficiency, the secretion of adrenaline does not increase, and the decomposition of glycogen cannot be promoted, so that blood sugar cannot rise and often remains at a low level. Glucagon deficiency can also cause hypoglycemia.

5. Matrix limitations

Ketotic hypoglycemia; maple syrup urine disease. 6. Glycogen storage disease

Among types of glycogen storage disease, hypoglycemia may occur in types I, III, IV, and O, among which type I glucose-6-phosphatase deficiency is more common.

7. Gluconeogenesis disorders

Impaired gluconeogenesis can cause hypoglycemia.

8. Defects in fatty acid oxidation

Fatty acid oxidation provides substrates for gluconeogenesis and also has an important effect on blood sugar. For example, congenital or drug-induced fatty acid metabolism defects can cause fasting hypoglycemia. Congenital deficiencies of various fat metabolizing enzymes can cause botulinum toxin deficiency or fatty acid metabolism defects, causing stagnation of fat metabolism and failure to generate ketone bodies, resulting in hypoglycemia, hepatomegaly, decreased muscle tone and convulsions.

9. Deficiency of other enzymes and other causes

Galactosemia; fructose intolerance; other liver damage; drug poisoning; reduced intestinal absorption; difficult to control hypoglycemic episodes.