Hypoglycemia in hypopituitary children
N. J. Hopwood, P. J. Forsman, F. M. Kenny and A. L. Drash
Fifty-two children with growth hormone (GH) deficiency were examined for
factors that might influence development of hypoglycemia. Symptomatic and
asymptomatic hypoglycemia occurred with equal frequency in children with
isolated GH and multiple anterior pituitary deficiencies. Of 52 children,
nine (17%) had symptomatic hypoglycemia and 14 (27%) had asymptomatic
hypoglycemia. Symptomatic hypoglycemia was more frequent in children who
were both young (less than 4 years of age) and lean (elevated height
age/weight age [HA/WA] ratio). With HGH therapy, these children had
decreases in HA/WA ratios and improvement in carbohydrate homeostasis.
Insulin responses to oral glucose and intravenous arginine administration
were substantially lowered in children with symptomatic hypoglycemia, A
deficiency of gluconeogenic substrate or impairment of amino acid
mobilization may be a factor in the development of hypoglycemia in
hypopituitarism similar to that postulated for ketotic hypoglycemia.
