Abstract
There is a dynamic equilibrium that maintains a constant and controlled supply of glucose to the tissues, whilst maintaining blood glucose in a narrow range, in both the fed and fasting state. This balance is primarily dependent on the hormonal control of glucose uptake by insulin into the muscles in the fed state, and by glucagon and counter-regulatory hormones leading to glucose release from the liver in the fasted state. If a child presents with abnormal blood glucose control, an understanding of the basic physiology of glucose metabolism can be a valuable guide for both diagnosis and further management. © 2006 Elsevier Ltd. All rights reserved.