BSPED2024 How Do I? How Do I? (Endocrine) (2 abstracts)
Royal Manchester Children's Hospital, Manchester, United Kingdom
Hypoglycaemia is a paediatric endocrine emergency requiring prompt action. A delay in recognition and treatment can result in brain injury and lifelong neurodisability. Severe and recurrent hypoglycaemia is likely to be caused by excess and unregulated insulin release in Congenital Hyperinsulinism (CHI), but other causes such as Adrenal Insufficiency should also be considered. The treatment of CHI can be difficult and complex and calls for a networked approach in conjunction with specialist centres. While CHI is mostly prevalent in neonates and young infants, idiopathic ketotic hypoglycaemia (IKH) is more common in older children. The treatment of IKH hinges on the prevention and use of emergency glucose regimens during periods of intercurrent illness; however, IKH can also be complex and unpredictable, requiring review by both endocrine and metabolic teams. Hypoglycaemia management can be challenging and resistant to therapies, particularly in CHI. On an optimistic note, there is considerable joined up effort from researchers, patient organisations and biotechnology industries to design new therapies and advanced methods of monitoring that may reduce the risk of neuroglycopaenia and preserve brain health.