• gastroenterology
• general paediatrics
• endocrinology
• paediatric practice
• physiology

Alteration of diet and fasting prior to endoscopy are necessary requirements to improve the quality of endoscopic view. For gastroscopy under general anaesthesia, they also reduce the risk of aspiration. Although important, similar measures have been shown to induce hypoglycaemia in children awaiting day case surgery.1 2 It is for this reason that children with diabetes are closely monitored during this preparation period. But how much consideration is given to non-diabetic children undergoing bowel preparation and fasting? Our recent audit has demonstrated significant hypoglycaemia in children undergoing outpatient colonoscopy, even in the absence of diabetes or metabolic disease.

We included 39 children who underwent outpatient endoscopy on our afternoon list. All children followed standardised protocols that allowed food until 6 hours before procedure and clear fluids until 2 hours before. Children with …