Pre-operative starvation in children. The role of alanine in blood glucose homeostasis.

Ninety-two children aged between 8 months and 8 years were fasted overnight prior to surgery. Plasma glucose and alanine concentrations were measured after the induction of anaesthesia. Of 30 children under four years, 23% had plasma glucose concentrations less than 3.3 mmol/litre. Underweight children were particularly at risk. The mean plasma alanine was low (0.17 mmol/litre) indicative of a shortfall in this essential substrate for gluconeogenesis. This probably reflects the greater obligatory glucose need of young children relative to their body protein mass.