ESPE Abstracts

Background: Hypoglycaemia is one of the most common presenting complaints at paediatric emergency department. There are many distinct causes of hypoglycaemia, ranging from nutritional insufficiency, infectious origins, to metabolic disorders. A thorough investigation can help differentiate the cause of hypoglycaemia, with subsequent tailored management. All patients with hypoglycaemia should have a full clinical assessment and together with a hypoglycaemia screen if appropriate.

Aim: This clinical review aims to determine investigation of hypoglycaemia in young children (≤ 6 years), and whether these patients received a subsequent diagnosis and adequate follow-up plan.

Methods: The local biochemistry laboratory information management system (LIMS) was searched for all children from 0 to 6 years-old, with hypoglycaemia defined as < 3.0 mmol/L from 2013-2021 at the Royal Hospital of Children, Glasgow. All cases were reviewed for the biochemistry investigations to determine if they had a full or partial hypoglycaemia screening requested and/or performed, the presenting complaint, clinical diagnosis, and subsequent follow-up arrangements.

Results: 501 children were identified with hypoglycaemia (< 3.0 mmol/L) over the nine-year period. Of these patients, around 28% (142/501) of patients had a full hypoglycaemia screen, 38% had a partial screen, and 34% (166/501) had no blood tests related to hypoglycaemia screening. The cause of hypoglycaemia was identified in 15 % (77/ 501) with gastroenteritis being the most common cause. Of those who were hypoglycaemic, 48 % had ongoing follow-up. Those with severe hypoglycaemia (≤ 1.5 mmol/L) (86/501), causes were identified in 72% (62/86) of the total hypoglycaemia incidence and 63 % (54/86) were followed up after first presentation.

Conclusions: Screening is not performed in all patients presenting with hypoglycaemia. A great portion of patients are not fully investigated and not followed up, including those with severe hypoglycaemia which can have long-term consequences and need to be managed appropriately.