GLUCOSE, THE BRAIN AND THE PEDIATRIC ENDOCRINOLOGIST

Hypoglycaemia remains one of the most confused and confusing issues in paediatric medicine. Controversy surrounds the definition of hypoglyc aemia: the mechanism of adverse effect on the brain, and the practical approach to monitoring, management and treatment. A personal conspect us is presented on why such controversies have arisen, before reviewin g recent advances in understanding the pathophysiology of hypoglycaemi a and its effects on the developing central nervous system. A practica l approach to the diagnosis of the cause of hypoglycaemia is presented which depends crucially upon measuring metabolic and endocrine interr elationships in the same blood sample obtained at the time of hypoglyc aemia.