Arpitha Kochiyanil, BMSc '26
Arpitha Kochiyanil
Hypoglycemia in Pediatric Growth Hormone Deficiency: Prevalence and Risk Factors
-Project supervised by Dr. Funmbi Babalola, completed in 2026
Abstract
Objective: To determine the prevalence of hypoglycemia in pediatric patients with growth hormone deficiency (GHD) and identify clinical, structural, and genetic factors associated with increased risk.
Background: Growth hormone plays a key role in maintaining glucose homeostasis. In children with GHD, impaired metabolic regulation can lead to hypoglycemia, which may result in serious neurological complications. Despite this, the frequency and predictors of hypoglycemia in pediatric GHD remain insufficiently characterized.
Data and Methods: A retrospective chart review was conducted at Children’s Hospital, London Health Sciences Centre, including pediatric patients aged 0–18 years with confirmed GHD. Data collected from electronic medical records included age at diagnosis, sex, pituitary MRI findings, genetic diagnoses, and hypoglycemia status. Statistical analyses included Mann–Whitney U tests, Fisher’s exact tests, and logistic regression to estimate associations between clinical variables and hypoglycemia.
Results: Fifty-three study participants had GHD; nine (17.0%) experienced documented hypoglycemia, of whom four had resolutions, three had persistent hypoglycemia, and two had unknown outcomes. Participants with hypoglycemia were diagnosed at a significantly younger median age (0.33 years; IQR: 0.00, 3.00) compared to those without hypoglycemia (median 6.5 years; IQR: 1.77, 12.00; p = 0.035). Abnormal pituitary MRI findings were strongly associated with hypoglycemia (OR = 47.8, 95% CI 8.9, 256.4, p < 0.001), as was the presence of multiple pituitary hormone deficiencies (MPHD; OR = 12.7, 95% CI 2.3, 69.5, p = 0.004). Sex was not significantly associated with hypoglycemia (p = 0.44). Genetic findings associated with hypoglycemia included pathogenic variants in HESX1 and structural anomalies such as septo-optic dysplasia and pituitary stalk interruption syndrome.
Conclusion: Hypoglycemia is a clinically significant complication in pediatric GHD and is strongly associated with early age at diagnosis and structural abnormalities of the hypothalamic-pituitary axis. These findings highlight the importance of early identification and targeted monitoring of high-risk patients to prevent adverse outcomes.
About Arpitha
Arpitha Kochiyanil is a fourth-year undergraduate student in the Honours Specialization in Epidemiology and Biostatistics at Western University. She completed her Year 4 Research Project under the supervision of Dr. Funmbi Babalola at Children’s Hospital, London Health Sciences Centre. Her research focuses on pediatric endocrine disorders, with particular interest in identifying clinical risk factors and improving early detection of metabolic complications. She is also involved in clinical research and has contributed to ongoing manuscript preparation for publication. Arpitha aims to pursue a career in medicine with a continued focus on research and evidence-based care.
