Ketotic hypoglycemia refers to low blood sugar levels with high levels of ketones. It commonly occurs in toddlers, often when they have not eaten over a long period of time or when they are ill.

Ketosis and hypoglycemia describe conditions that affect energy use and blood sugar levels. Ketosis happens when the body breaks down fats instead of carbohydrates for energy, producing acids known as ketones. Hypoglycemia occurs when blood sugar levels drop too low. When these two conditions occur together, it is known as ketotic hypoglycemia.

Ketotic hypoglycemia is the most common cause of hypoglycemia for children in emergency departments. It is typically the result of illnesses that reduce how much a child consumes or periods of fasting or vomiting.

Children with ketotic hypoglycemia can experience symptoms of irritability, tiredness, and shakiness. Doctors will use sugar to treat the condition, which should quickly reduce symptoms. However, they may also suggest a period of monitoring where necessary.

A young child around the age when ketotic hypoglycemia is most common-2.Share on Pinterest
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Ketotic hypoglycemia is a combination of low blood sugar, or hypoglycemia, and elevated ketones, known as ketosis. The liver produces ketones when the body breaks down fats for energy. It typically occurs when the body lacks glucose for energy and starts to break down fats instead.

A healthy range of glucose in the blood is usually around 70 to 150 milligrams of glucose per deciliter (mg/dL) of blood. However, certain labs may show slight variations in this range.

Ketones are a sign that the body is breaking down fats. Doctors can detect elevated ketones with urine or blood tests. There are no formal thresholds for diagnosing elevated ketones in the body.

Ketotic hypoglycemia can occur without diabetes.

Diabetes is a condition that impairs how the body processes blood glucose. This can result in high blood glucose, or hyperglycemia, which leads to several other health problems around the body over time.

Diabetes is also a common cause of hypoglycemia. However, ketotic hypoglycemia can appear in otherwise healthy children. The condition is rare in healthy children beyond the newborn period. Most children will outgrow ketotic hypoglycemia by the age of 5 to 6 years.

Ketotic hypoglycemia is the result of low blood glucose and elevated ketones as a result of the body breaking down fats for energy.

The exact cause of ketotic hypoglycemia is unclear. The Pediatric Endocrine Society highlights two potential problems in children with ketotic hypoglycemia: Increased use of energy stored in the liver and a quicker switch to breaking down fats for energy, and, sometimes, an inability to effectively store fat and muscle energy to keep blood glucose up.

Children presenting to emergency departments with hypoglycemia usually have ketotic hypoglycemia. In these cases, common causes include reduced food intake due to an illness, particularly gastrointestinal problems with vomiting and fasting. Long periods without eating can cause ketotic hypoglycemia in children.

Ketotic hypoglycemia is more common in young children.

Children are particularly vulnerable because their bodies have higher energy demands and lower reserves of stored glucose. Children typically overcome this condition by ages 5 to 6 as their bodies improve at managing blood sugar levels.

However, there are some rare cases of ketotic hypoglycemia in adults.

Common symptoms of hypoglycemia include:

In rare cases, ketotic hypoglycemia can cause more serious symptoms, such as seizures.

Read on to learn more about the symptoms of hypoglycemia in children.

There are no specific treatments for ketotic hypoglycemia beyond giving sugar. Symptoms should improve when a child eats or drinks something containing sugar. For example, they may consume fruit juice or soda.

In other cases, a doctor may recommend giving glucose directly into the bloodstream. Blood glucose should return to normal within minutes of consuming sugar or receiving glucose in the bloodstream.

Doctors may ask about a child’s diet and provide advice on how to ensure they have enough sugar and avoid long periods of fasting, where that is a problem. Families may also need to monitor glucose and ketones where the problem is ongoing.

Ketotic hypoglycemia occurs when the body experiences low blood sugar levels, causing it to break down fats to produce ketones. It typically affects young children and causes tiredness, irritability, and shakiness. Most children will outgrow the condition as their body develops and gets better at regulating blood sugar levels.

The condition can occur without diabetes and typically only affects children. The causes of ketotic hypoglycemia are not always clear, but it can be the result of an illness or a long period of fasting. Doctors typically treat the condition with sugar, but there may also be a period of monitoring where the condition is ongoing.