The typical patient with<unk>  is a young child between the ages of 10 months and 6 years. Episodes nearly always occur in the morning after an overnight fast, often one that is longer than usual. Symptoms include those of neuroglycopenia, ketosis, or both. The neuroglycopenic symptoms usually include lethargy and malaise, but may include unresponsiveness or seizures. The principal symptoms of ketosis are anorexia, abdominal discomfort, and nausea, sometimes progressing to vomiting. If severe, parents usually take the child to a local emergency department, where blood is drawn. The glucose is usually found to be between 35 and 60 mg/dl (1.8-3.1 mmol/L). The total CO2 is usually somewhat low as well, (14-19 mmol/L is typical), and if urine is obtained, high levels of ketones are discovered. Ketones can also be measured in the blood at the bedside (Medisense glucometer). Other routine tests are normal. If given intravenous fluids with saline and dextrose, the child improves dramatically and is usually restored to normal health within a few hours. These symptoms are normally seen because of the child being unadapted to using fat as energy, typically when the child's daily glucose intake might be too high (more than 50g/day for a child). This is also associated with fluctuant glycemia throughout the day. A first episode is usually attributed to a viral infection or acute gastroenteritis. However, in most of these children one or more additional episodes recur over next few years and become immediately recognizable to the parents. In mild cases, carbohydrates and a few hours of sleep will be enough to end the symptoms. Precipitating factors, conditions that trigger an episode, may include extended fasting (e.g., missing supper the night before), a low carbohydrate intake the previous day (e.g., a hot dog without a bun), or stress such as a viral infection. Most children affected by<unk>  have a slender build, many with a weight percentile below height percentile, though without other evidence of malnutrition. Overweight children are rarely affected.<unk>  in glycogen storage disease Some of the subtypes of glycogen storage disease show<unk>  after fasting periods. Especially glycogen storage disease type IX can be a common cause for<unk> , with the most common sub-type IXa mainly affecting boys. With glycogen storage disease type XIa, children can usually appear overweight for height, but this is attributed to an enlarged liver (hepatomegaly).
Ketotic hypoglycemia
Reactive hypoglycemia
Hyperinsulinemic hypoglycemia
Diabetic hypoglycemia
Idiopathic hypoglycemia
Stress hyperglycemia
Hyperproinsulinemia
Ketosis-prone diabetes