Talk:Ketotic hypoglycemia

Wiki Education assignment: WikiMed UTSW
— 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)