The challenges in managing perioperative hypoglycemia in a child on modified Atkins diet

Our patient is a 5-year-old boy with West syndrome, complicated by neurodevelopmental delays, scheduled for elective gastrostomy. He was started on MAD 6 months prior to surgery. His oral anti-epileptics were converted to intravenous equivalents during fasting. Non-dextrose containing solution was used as maintenance fluid. Blood glucose was monitored 4-hourly when fasting commenced 6h before surgery. His serial blood glucose is summarized in Table 1. This article is protected by copyright. All rights reserved.