Abstract
Fasting has been the most useful general test for diagnosis of hypoglycemia in children but may require 36 to 48 hours. 2-De-oxyglucose (2DG) is a competitive inhibitor of glucose transport which rapidly and selectively stimulates the hypothalamic counter-regulatory response to hypoglycemia. 2DG was evaluated as an alternative to fasting by administering both fasting and 2DG tests to 7 children found to be normal and to 14 found to have fasting hypoglycemia (ages 2 to 11). 2DG (50 mg/kg) was given IV over 30 minutes and samples collected for 3 hours. In the normal children glucose increased 30 mg% (14 to 54). In the hypoglycemic children glucose did not increase (-30 to +3 mg%) (p < .001). Insulin remained at low fasting levels except in one child with an insulinoma. Normal children excreted urinary epinephrine at a maximum of 310 ng/mg creatinine (250 to 430) 2 to 3 hours after 2DG. This was greater than the maximum after fasting, 130 ng/mg creatinine (20 to 310). In 11 of the hypoglycemic children the maximum epinephrine excretion after 2DG was well below the normal range (20 to 200 ng/mg creatinine) and no other cause of hypoglycemia was found. The 2DG test is therefore superior to fasting in identifying epinephrine deficiency. It is concluded that the glucose response to 2DG is as reliable as fasting in distinguishing normal from hypoglycemic children and has the advantage of being more rapid without producing symptoms.
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Hansen, I., Levy, M., Kerr, D. et al. USE OF 2-DEOXYGLUCOSE AS AN ALTERNATIVE TO FASTING FOR DIAGNOSIS OF HYPOGLYCEMIA. Pediatr Res 11, 515 (1977). https://doi.org/10.1203/00006450-197704000-00872
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DOI: https://doi.org/10.1203/00006450-197704000-00872