Talk:Ketotic hypoglycemia

Wiki Education assignment: WikiMed UTSW

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 November 2023 and 15 December 2023. Further details are available on the course page. Student editor(s): Baflyer2 (article contribs).

— Assignment last updated by Baflyer2 (talk) 14:48, 22 November 2023 (UTC)

Outline of proposed changes: Overall, need to reorganize flow of article: causes, signs/symptoms, diagnosis, natural history, treatment

Introduction

• Include brief definition of ketosis, since this is missing
• "It remains one of the most common causes of hypoglycemia in the age range" --> in what specific age range? I think this is trying to say "in children" --> double check reference
• Should also briefly discuss that "ketotic hypoglycemia" encompasses both a physiological and pathological state

Physiologic KH

• Normal response to acute stressors such as infection, fever
• Briefly review physiology (need for continuous fuel source for brain, in absence of available glycogen ---> fatty acid oxidation and ketosis)
• Children tend to outgrow this with age

Pathologic KH

• Metabolic derangement caused by hormone deficiency, glycogen storage disorder

• Some of what is included in the signs/symptoms section probably should be in the treatment section (e.g. treatment with saline/dextrose)
• Ketotic hypoglycemia in glycogen storage disorders should probably be in the "Causes" section instead of the signs/symptoms section
• Other causes: Silver-Russel syndrome

Diagnosis

• Include definitions: Christesen et al paper defines pathological IKH as beta-hydroxybutyrate > 1.0 mmol/L and blood glucose < 70 mg/dL (in absence of other cause)

Treatment

• Management for physiologic KH is treatment of the underlying cause
• POC glucometer
• Corn starch vs G tube (in cases of severe KH)
• IM glucagon, IV saline/dextrose (inpatient management)

Baflyer2 (talk) 14:48, 22 November 2023 (UTC)

12/10/23 Peer Review General Notes:

• Great job on the detailed workplan
• Good job on adding some definitions that were previously missing
• Great job on reorganizing the information in the "Signs and Symptoms" section
• There is quite a bit of medical jargon present which may be confusing to a reader from a non-medical background, so consider reducing jargon usage and replacing with everyday language when possible
• Consider adding more graphics/illustrations and links in the text

Introduction

• Great job on defining ketosis
• Good job on differentiating between different categories/causes of KH
• However, a general reader may not necessarily understand what "physiologic" or "pathologic" actually mean, so consider further defining those terms and/or linking to articles on those topics (if available)

Physiologic KH

• While this section generally makes sense from a scientific standpoint, it seems a bit jargon-heavy for a general audience
• Again, a general reader may not understand what the word "physiologic" means, so consider defining it first
• Several scientific terms which are mentioned here are not defined, including "glycogenolysis," "gluconeogenesis," and "lipolysis," which may be somewhat confusing for a general reader
• Consider adding an image to help illustrate the physiology

Pathologic KH

• A general reader probably won't understand what "glucose homeostasis" means
• Good examples of genetic disorders provided

Signs and Symptoms

• Great job at reorganizing the info between this section and the "Causes" and "Treatment" sections

Diagnosis

• Great job at including the pathological IKH definition
• Some medical jargon terms used here may not be familiar for a general reader, including "ketone transporter," "inpatient," "point-of-care," "gastrostomy tube feeding," and "indicated"

Treatment

• Some medical jargon present in this section may be confusing for a general reader, including "fluid resuscitation," "buccal," and "intravenous"
• Consider including a graphic of gluconeogenesis with alanine circled so the reader has a clearer idea of what gluconeogenesis is and why alanine is important
• Consider adding more links in the text

Rrwu96 (talk) 22:25, 10 December 2023 (UTC)