How is reactive hypoglycemia diagnosed?
Reactive hypoglycemia can be diagnosed by measuring the amount of glucose in a person's blood while they're having symptoms as well as by observing if their symptoms resolve once they eat and their blood glucose levels return to normal.
If the person’s results show a blood glucose level below 70 milligrams per deciliter (mg/dL) while they are having symptoms, a healthcare provider may order a mixed meal tolerance test (MMTT). For this test, a person drinks a high-calorie beverage that contains protein, carbohydrates, and fat such as Ensure or Boost.
Before taking the MMTT and every 30 minutes for five hours, your healthcare provider will test blood glucose levels as well as insulin, proinsulin (an insulin precursor), and another substance produced by the pancreas alongside insulin.
What is reactive hypoglycemia?
Reactive hypoglycemia is when blood glucose (blood sugar) levels drop within four hours of eating or when fasting and is not related to diabetes. Rarely, blood sugar levels may drop randomly unrelated to food intake or deprivation. Reactive hypoglycemia may also be called postprandial hypoglycemia.
What causes reactive hypoglycemia?
Usually, no cause is found, but reactive hypoglycemia is more common in some medical conditions such as noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS), gastric bypass surgery, tumors, ulcer treatment, metabolic disorders, and insulin autoimmune hypoglycemia. It is more common in people who are overweight.
It may occur in some people after a carbohydrate-heavy meal. In many cases, it appears the body continues to release extra insulin even after a meal has been digested. This added insulin makes your blood glucose level drop below normal.
Related Questions
- What foods should I eat or avoid for hypoglycemia?
- Can you have hypoglycemia without diabetes?
- What’s the difference between hypoglycemia and hyperglycemia?
What are the symptoms of reactive hypoglycemia?
Symptoms usually start within 4 hours of a meal, or when a person has been fasting for some time and may include:
- Anxiety
- Blurred vision
- Rapid heart rate
- Confusion
- Dizziness or feeling faint
- Extreme tiredness
- Irritability
- Headache
- Hunger
- Light-headedness
- Sweating
- Tremor or shaking
- Trouble sleeping
- Weakness.
How do you treat reactive hypoglycemia?
Most people can manage their reactive hypoglycemia with lifestyle changes, for example:
- Eat smaller meals and snacks about every 3 hours
- Include a variety of foods in your diet, such as protein (meat and nonmeat), fruits and vegetables, dairy products, and whole grains
- Avoid high sugar foods and highly refined carbohydrates, such as white bread
- If you drink alcohol, eat food
- Get regular exercise.
References
- DiLonardo MJ. Dansinger M. What Is Reactive Hypoglycemia? January 03, 2020, WebMD. https://www.webmd.com/a-to-z-guides/reactive-hypoglycemia
- Vella A, Nathan D, Mulder J. Postprandial (reactive) hypoglycemia. Up to Date. https://www.uptodate.com/contents/postprandial-reactive-hypoglycemia#subscribeMessage
Read next
Related medical questions
- Are glucagon and glycogen the same thing?
- How do beta-blockers mask hypoglycemia?
- Should you use a diuretic with diazoxide?
- When should you use glucagon?
- What are the signs and symptoms of hypoglycemia?
- What's the buzz on Ozempic and Wegovy?
- How long does Baqsimi last?
- How much does Baqsimi cost?
- Is Baqsimi covered by Medicare?
- How do you use Baqsimi nasal powder?
- Is diazoxide a vasodilator?
- How does diazoxide slow insulin?
- How do you use the Gvoke HypoPen?
- What is Gvoke (glucagon) used for and how does it work?
- How do you use the GlucaGen hypokit?
- Is a Continuous Glucose Monitor right for me?
- How do I choose a Blood Sugar Monitoring Device?
- What causes hypoglycemia when managing diabetes with insulin?
Related support groups
- Hypoglycemia (39 questions, 60 members)