Infant masking of recurrent hypoglycaemia and metabolic disease.

Hypoglycaemia is more common in childhood compared with adolescents and adults, as children have reduced ability to maintain glucose homeostasis. During illnesses, periods of fasting can accelerate a switch to ketosis. Thus, a presumptive misdiagnosis of recurrent hypoglycaemia due to accelerated starvation may be made due to cognitive biases.The diagnosis of other pathological causes of hypoglycaemia may be difficult and delayed. It is missed in up to 28% of cases. One confounder is a child's ability to mask hypoglycaemia through altered feeding, such as frequent breastfeeding. The potential overlay from confounders must be closely considered in younger children presenting with hypoglycaemia.