The ketogenic diet (KD) is an effective treatment for intractable epilepsy in children. Hypoglycemia can be one of its side-effects, which is considered to be present mainly during the introductory phase of KD. Continuous glucose monitoring in a 6-year old non-diabetic child treated with KD for more than 8 months revealed long periods of asymptomatic hypoglycemia (8.9% of the total time under 2.5 mmol/l, 10.6% of the total time in the range between 2.5-3.0, 29.1% in the range of 3.0-3.6 mmol/l). The episodes of serious hypoglycemia were associated with a fasting state. The amount of sacharides in KD was increased with substantial glycemic profile improvement.

Department of Internal Medicine 2nd Faculty of Medicine v Úvalu 84 15000 Prague 5 Czech Republic

Department of Internal Medicine 3rd Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic Center of Nutrition Thomayer Hospital Vídeňská 800 140 59 Prague 4 Czech Republic

Department of Pediatric Neurology Thomayer Hospital Vídeňská 800 140 59 Prague 4 Czech Republic

Institute of Computer Science Academy of Science of the Czech Republic v v i Narodni 3 117 20 Prague 1 Czech Republic

Dynamics of glucose concentration during the initiation of ketogenic diet treatment in children with refractory epilepsy: Results of continuous glucose monitoring