Hypoglycemia Prolonged fast (Eg. Malnutrition*, Neglect*, Disordered Eating*) Prematurity* Small for Gestational Age* Hyperinsulinism Decreased Counter-regulation Panhypopituitarism Growth hormone deficiency ACTH deficiency Hypothyroid Adrenal insufficiency Sepsis* Congestive Heart Failure* Renal Failure* Shock* Poisoning/Intoxication* (Eg. Insulin, Sulfonylurea drugs) — Metabolic Disease* Decreased Substrate Endocrine Metabolic Increased Demand *Indicates Key Condition This is not an exhaustive list of medical conditions. Suspect in any child who is unwell, and with a decreased level of consciousness Neonates <2.6 mmol/L Beyond neonatal period <4.0 mmol/L Potentially acutely life-threatening presentation

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