KETOTIC HYPOGLYCEMIA OF CHILDHOOD—A CLINICAL TRIAL OF SEVERAL UNIFYING ETIOLOGICAL HYPOTHESES

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Abstract
Children (15) with suspected ketotic hypoglycemia were investigated according to a program designed to test several hypotheses postulated to explain the etiology of ketotic hypoglycemia. The classical ketogenic provocation with a low calorie/high fat diet was used and the blood levels of several substrates and hormones and the urinary excretion of certain metabolites and hormones were measured. Of the 15 children, 6 will fill the criteria of ketotic hypoglycemia at the time of study. These 6 children did not decrease their peripheral glucose utilization (measured as Kg [before and after ketogenic diet]) during starvation. These 6 children seemed to be more advanced in their adaptation to ketogenic diet in all other parameters studied. The children with ketotic hypoglycemia did not differ from the other children in plasma level of cortisol or urinary excretion of N, urea, 3-methylhistidine and catecholamines. The children with ketotic hypoglycemia apparently represent the tail of the gaussian curve in the normal age-dependent development of the adaptation to starvation.