BACKGROUND: Hypoglycemia is one of the most common metabolic derangements in childhood. To establish the cause of hypoglycemia, fasting tolerance tests can be used. Currently available reference values for fasting tolerance tests have limitations in their use in daily practice. OBJECTIVE: The aim of this study was to determine the reference values of metabolites involved in glucose homeostasis during fasting in healthy children. METHODS: This study included a retrospective analysis of 488 fasting tests. All tests of patients (n = 321) with disorders, including metabolic and endocrine disorders, were excluded, as were tests performed in children who were over- or underweight. RESULTS: In 167 fasting tests performed in the study, hypoglycemia was reached in 52 (31%) tests. On the basis of the time until hypoglycemia was reached, 3 age groups could be defined: (1) children aged 0 to 24 months (median 15 months) (n = 49); (2) children aged 25 to 84 months (median 45 months) (n = 79); (3) and children aged 85 to 216 months (median 106 months) (n = 39). In all groups, a significant increase in ketone body levels and a significant decrease in glucose levels in plasma were observed during fasting. Younger children had a faster increase in ketone body levels and a faster decrease in glucose levels in plasma than older children. CONCLUSIONS: Reference values of the metabolites involved in glucose homeostasis during fasting in children were generated. Those values can be used to determine whether a child has a normal fasting response. For high-risk children, guidelines concerning maximum fasting time and dietary intervention during illness are of the utmost importance.
BACKGROUND:Hypoglycemia is one of the most common metabolic derangements in childhood. To establish the cause of hypoglycemia, fasting tolerance tests can be used. Currently available reference values for fasting tolerance tests have limitations in their use in daily practice. OBJECTIVE: The aim of this study was to determine the reference values of metabolites involved in glucose homeostasis during fasting in healthy children. METHODS: This study included a retrospective analysis of 488 fasting tests. All tests of patients (n = 321) with disorders, including metabolic and endocrine disorders, were excluded, as were tests performed in children who were over- or underweight. RESULTS: In 167 fasting tests performed in the study, hypoglycemia was reached in 52 (31%) tests. On the basis of the time until hypoglycemia was reached, 3 age groups could be defined: (1) children aged 0 to 24 months (median 15 months) (n = 49); (2) children aged 25 to 84 months (median 45 months) (n = 79); (3) and children aged 85 to 216 months (median 106 months) (n = 39). In all groups, a significant increase in ketone body levels and a significant decrease in glucose levels in plasma were observed during fasting. Younger children had a faster increase in ketone body levels and a faster decrease in glucose levels in plasma than older children. CONCLUSIONS: Reference values of the metabolites involved in glucose homeostasis during fasting in children were generated. Those values can be used to determine whether a child has a normal fasting response. For high-risk children, guidelines concerning maximum fasting time and dietary intervention during illness are of the utmost importance.
Authors: Elizabeth Rosenfeld; Kelly D Getz; Tamara P Miller; Alix E Seif; Brian T Fisher; Evanette Burrows; Mark Jason Ramos; Diva D De León; Richard Aplenc; Knashawn H Morales; James P Guevara Journal: Pediatr Blood Cancer Date: 2021-11-22 Impact factor: 3.838
Authors: Beth A Drolet; Peter C Frommelt; Sarah L Chamlin; Anita Haggstrom; Nancy M Bauman; Yvonne E Chiu; Robert H Chun; Maria C Garzon; Kristen E Holland; Leonardo Liberman; Susan MacLellan-Tobert; Anthony J Mancini; Denise Metry; Katherine B Puttgen; Marcia Seefeldt; Robert Sidbury; Kendra M Ward; Francine Blei; Eulalia Baselga; Laura Cassidy; David H Darrow; Shawna Joachim; Eun-Kyung M Kwon; Kari Martin; Jonathan Perkins; Dawn H Siegel; Robert J Boucek; Ilona J Frieden Journal: Pediatrics Date: 2012-12-24 Impact factor: 7.124
Authors: Irene J Hoogeveen; Rixt M van der Ende; Francjan J van Spronsen; Foekje de Boer; M Rebecca Heiner-Fokkema; Terry G J Derks Journal: JIMD Rep Date: 2015-11-03
Authors: Catharina M L Touw; G Peter A Smit; Klary E Niezen-Koning; Conny Bosgraaf-de Boer; Albert Gerding; Dirk-Jan Reijngoud; Terry G J Derks Journal: Orphanet J Rare Dis Date: 2013-03-20 Impact factor: 4.123