In healthy persons, complex regulatory systems maintain a constant level of glucose in the blood. Unfortunately, certain medical conditions may impair the ability of the body to maintain glucose levels, and hypoglycemia results. Chronic ethanol users are at increased risk for hypoglycemia due to diminished glycogen supply and impaired gluconeogenesis. Persons at extremes of age are also potentially at increased risk for hypoglycemia. Young children have a disproportionately higher brain requirement for glucose as well as smaller glycogen reserves. The elderly may have health problems that alter the normal counterregulatory response to hypoglycemia as well as contribute to hypoglycemia (e.g., hepatic or renal disease). Older patients are also more likely to be taking medications that may exacerbate hypoglycemia or blunt the normal response to hypoglycemia (e.g., b-adrenergic antagonists).
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