Fig. 3
From: Food triggers and inherited metabolic disorders: a challenge to the pediatrician
Diagnostic algorithm to guide the initial approach to hypoglycemia, based on the liver size and the timing of hypoglycemia. Postprandial hypoglycemias of HFI and galactosemias differentiate these disorders from others characterized by fasting or unpredictable hypoglycemias. Hypoglycemias in HI/HA are induced both by fasting and by protein-rich meals (leucine sensitivity). Disorders with similar presenting features are shown as differential diagnosis. Abbreviations: CDG congenital defect of glycosylation, FAODs fatty acid oxidation defects, FBPase deficiency fructose-1,6-bisphospatase deficiency, HI/HA hyperinsulinism hyperammonemia syndrome, MCAD medium-chain acyl-CoA dehydrogenase deficiency, SCAD short-chain acyl-CoA dehydrogenase deficiency, SCHAD short-chain 3-hydroxyacyl-CoA dehydrogenase