Reactive hypoglycemia

What is Reactive Hypoglycemia?

It is a medical condition characterized by repeated occurrences of symptomatic hypoglycemia that takes place within every 4 hours following a high-carbohydrate meal in individuals who are not having clinical diabetes. The condition is believed to be due to the release of excessive insulin that is triggered by the high-carbohydrate meal, even though it continues past the digestion and removal of the glucose that is derived from that meal.

Reactive hypoglycemia is also known as postprandial hypoglycemia.

Reactive Hypoglycemia Types

There are different types of this disease, such as:

  • Alimentary hypoglycemia, resulting from dumping syndrome. The condition occurs in almost 15% of individuals having stomach surgery
  • Hormonal hypoglycemia, might result from hormonal difficulties such as hypothyroidism
  • Congenital enzyme deficiencies, might occur from galactosemia, hereditary fructose intolerance and leucine sensitivity during childhood
  • Gastritis induced by Helicobacter pylori – in some cases, reactive hypoglycemia can be caused by the H. pylori bacteria
  • Late hypoglycemia – this condition might develop as a result of occult diabetes

Reactive Hypoglycemia Causes

The exact factors responsible for the causation of reactive hypoglycemia are still not known and open to debate. However, several hypotheses have been presented to explain why this condition might develop in certain individuals. These include:

  • Sensitivity to the hormone epinephrine which is released by the body during stressful times
  • Deficiencies in the secretion of glucagon; glucagon is also a hormone that can raise the blood glucose levels
  • Gastric surgeries, as the food might pass too swiftly through the digestive system of patients
  • Hereditary fructose intolerance
  • Enzyme deficiencies, although such instances are uncommon and mostly occur during infancy
  • Consumption of alcohol
  • Withdrawal of D-chiro-inositol or myo-inositol might lead to temporary reactive hypoglycemia

Reactive Hypoglycemia Symptoms

The symptoms of the disorder might vary according to the hydration level of a patient as well as the magnitude of and/or his or her sensitivity to the decline of blood glucose concentration. The various signs and symptoms exhibited by the sufferers of reactive hypoglycemia include:

  • Coma
  • Fatigue
  • Nausea
  • Rhinitis
  • Anxiety
  • Tremors
  • Flushing
  • Dizziness
  • Vomiting
  • Sweating
  • Irritability
  • Confusion
  • Numbness
  • Headaches
  • Depression
  • Nervousness
  • Panic attacks
  • Mood swings
  • Muscle twitches
  • Unclear thinking
  • Sleeping Trouble
  • Light-headedness
  • Craving for sweets
  • Increased appetite
  • Coldness in extremities
  • Blurry vision or double vision
  • Heart palpitations or fibrillation

Reactive Hypoglycemia Diagnosis

In order to determine whether or not a person is having reactive hypoglycemia, a doctor is likely to recommend having an HbA1c test that will measure the average of blood sugar taken over the past 2 to 3 months. The 6-hour glucose tolerance test is another important exam which can help to chart the blood sugar levels during the past 6 hours. According to the diagnostic criteria presented by the U.S. National Institute of Health (NIH), if a patient has blood glucose level lower than 70 mg/dL while he or she is experiencing the symptoms which is then followed by relaxation after eating, it then confirms the diagnosis for this condition. The doctor may also conduct liver function and kidney function tests as well as evaluate adrenal gland functions to rule out the possibilities of other similar health disorders.

Reactive Hypoglycemia Treatment

The signs and symptoms of the disease can be managed by observing the following steps:

  • Eating snacks and small meals in almost every 3 hours
  • Avoiding or limiting the intake of sugar
  • Following a regular regime of exercises; exercising helps in absorption of sugar which reduces release of excessive insulin;
  • Consuming various types of foods such as fish, meat and poultry or non-meat sources of protein, like fruits, vegetables, whole-grains, and dairy products;
  • Including high-fiber foods in the diet

Adapting to a low-carbohydrate diet, which involves frequent small meals, is recommended as the initial treatment for this condition. Small meals should be taken during mid-mornings and then again in the afternoon, when reactive hypoglycemia would start decreasing. Fall in the levels of blood glucose is prevented if one can take appropriate combination of the meal. Reactive hypoglycemia patients should stay away from rapidly absorbable sugars. They should avoid soft drinks that are rich in sucrose or glucose, or avoid drinks combining alcohol and sugar, especially while fasting.

Reactive Hypoglycemia Diet

As Reactive hypoglycemia is not associated with diabetes, a patient does not need to follow a strict diabetic diet. However, some of the dietary recommendations that are generally made for diabetics allow a patient of this condition to control his or her low blood sugar. Sufferers should follow a tailor-made diet pain to manage their health condition, which should include limited intake of sugar and carbohydrates as well as have high-fiber foods that help in slowing digestion. Patients should eat every 2 hours in order to regularly supply their bodies with glucose and avoid alcohol consumption which may trigger symptoms associated with low blood sugar. Eating and drinking prior to exercising is mandatory as this helps to maintain necessary levels of glucose, thereby avoiding hypoglycemia.

A combination of proteins, fats and complex carbohydrates is recommended for patients every time they eat. A large high-calorie diet or a large meal is best avoided if one is eating in every 2 or 3 hours as this may lead to excessive calorie intake which might lead to gaining weight. The following combinations will allow stabilizing the glucose levels as well as providing the body with essential nutrients.

  • Cottage cheese or yogurt with fruits and nuts
  • Lean meat sandwiches such as those with turkey
  • Nut butter with crackers or whole grain bread
  • Tuna or chicken on a whole wheat bread
  • Salad with cheese and beans
  • Bean soup accompanied by whole grain crackers

The diet should be rich in fruits, legumes, vegetables and whole grains. Although one is not required to curb carbohydrate intake wholly, he or she should choose carbohydrate foods that does not affect the blood sugar levels quickly.

Caffeine can adversely affect one’s levels of blood sugar. Although each individual responds to caffeine in a different manner, most people having reactive hypoglycemia will do well either by eliminating it completely or by limiting it to the bare minimum. Intake of both fibers and fluid should be increased. Fibers help in stabilizing the glucose and water will assist in avoiding gastric distress with increase of fiber in the diet. It is advisable to carry a snack at all times; eating at first signs of Reactive hypoglycemia can prevent the symptoms from getting any worse. The best way to combat this disorder is by eating.

Reactive Hypoglycemia Prognosis

Although there are no permanent cures for Reactive hypoglycemia, maintaining a strict diet plan and regularly coordinating with the physician will allow an individual to manage the symptoms associated with this condition. The number of hypoglycemic attacks can be reduced over time with close monitoring of the condition as well as by following a diet plan that is tailor-made to meet the requirements of individual patients.

Reactive hypoglycemia can give rise to several critical symptoms. Treatment is mostly aimed at managing its symptoms. Sticking to a proper diet plan is necessary for the well being of patients.

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