High levels of uric acid in the blood and attendant risk of gout or kidney damage, caused by low serum insulin levels in prolonged hypoglycemia High levels of lactic acid in the blood, in extreme cases leading to lactic acidosis, caused by prolonged hypoglycemia[1] hepatic adenomas developing in adulthood[11] and attendant risk of anemia,[12] suspected to be caused by blood glucose dysregulation in the presence of non-alcoholic fatty liver disease in GSD Ib, inflammatory bowel disease and attendant risk of anemia,[12] caused by neutrophil dysfunction and exacerbated by the increased carbohydrate intake required to prevent hypoglycemia[4]