Reactive hypoglycemia, or postprandial hypoglycemia, is a condition characterized by a decrease in blood glucose levels up to 4 hours after a meal, and is also accompanied by typical symptoms of hypoglycemia, such as headache, tremors and dizziness.
This condition is often not diagnosed correctly, being considered just a situation of common hypoglycemia and that would be related to stress, anxiety, irritable bowel syndrome, migraine and food intolerances, for example. However, reactive hypoglycemia needs to be properly diagnosed so that its cause can be investigated and appropriate treatment can be performed, since dietary changes are not sufficient to treat reactive hypoglycemia.
How is the diagnosis of reactive hypoglycemia
Because the symptoms of reactive hypoglycemia are the same as those of common hypoglycemia, the diagnosis is often made the wrong way.
Therefore, in order to make the diagnosis of postprandial hypoglycemia, the Whipple triad must be considered, in which the person must present the following factors in order for the diagnosis to be concluded:
- Symptoms of hypoglycemia; Blood glucose concentration measured in the laboratory below 50 mg / dL; Improvement of symptoms after consumption of carbohydrates.
In order to have a better interpretation of the symptoms and the values obtained, it is recommended that if the reactive hypoglycemia is investigated, the person who presents symptoms should go to the laboratory and have blood collected after the meal and remain in place for about 5 hours. This is because the improvement of the symptoms of hypoglycemia after carbohydrate consumption must also be observed, which should happen after collection.
Thus, if low circulating glucose concentrations are found in the blood test and improvement of symptoms after consumption of carbohydrates, postprandial hypoglycemia is conclusive, and investigation is recommended to initiate the most appropriate treatment.
Main causes
Reactive hypoglycemia is a consequence of unusual diseases and, therefore, the diagnosis of this condition is often wrong. The main causes of reactive hypoglycemia are hereditary fructose intolerance, post-bariatric surgery syndrome and insulinoma, which is a condition characterized by excess production of insulin by the pancreas, with a rapid and excessive decrease in the amount of circulating glucose. Learn more about insulinoma.
Symptoms of reactive hypoglycemia
The symptoms of reactive hypoglycemia are related to the decrease in the amount of glucose circulating in the blood and, therefore, the symptoms are the same as that of a hypoglycemia resulting from the use of some medications or prolonged fasting, the main ones being:
- Headache; Hunger; Shivering; Sickness; Cold sweat; Dizziness; Tiredness; Drowsiness or agitation; Palpitations; Difficulty in reasoning.
For the reactive hypoglycemia to be confirmed, it is necessary that in addition to the symptoms, the person has low amounts of glucose circulating in the blood after the meal and that the symptoms improve after consuming sugary foods. The identification of the cause is important to start the treatment, which is established by the endocrinologist according to the cause.
