What to Know About Reactive Hypoglycemia

Rolf Bruderer/Blend Images/Getty Images

Hypoglycemia, or low blood sugar, is most common among people with diabetes. But something called reactive hypoglycemia can occur in people who do not have diabetes. Also known as postprandial hypoglycemia, it occurs after meals—typically within four hours of eating. Although the symptoms are the same as those who have low blood sugar with diabetes, the causes are different. One of the most important things in figuring out how to manage this is to determine the cause of hypoglycemia.

Symptoms of Reactive Hypoglycemia

The signs and symptoms of hypoglycemia can be unnerving, especially if it's your first time experiencing an episode. Here are some of the symptoms you may experience when you have reactive hypoglycemia:

  • Trembling or weakness
  • Anxiety
  • Lack of coordination
  • Drowsiness or confusion
  • Headache
  • Dizziness
  • Double vision
  • Convulsions or unconsciousness

Note that you could be having these symptoms without actually having a low blood sugar. To properly identify the cause of your symptoms and if you are in fact experiencing reactive hypoglycemia it's important to go to your healthcare provider for an evaluation.

Causes of Reactive Hypoglycemia

The exact cause of reactive hypoglycemia is not always clear, but there are several hypotheses that might explain why it can happen. These theories include:

  • Sensitivity to epinephrine, a hormone that is released in the body during times of stress.
  • Insufficient glucagon production. Glucagon is a hormone which has the opposite effect of insulin, meaning it raises blood glucose levels.
  • Gastric surgery can also cause reactive hypoglycemia because food may pass too quickly through the digestive system, without all of it being digested and absorbed as glucose into the bloodstream.
  • Enzyme deficiencies can also cause reactive hypoglycemia, but these are rare and occur during infancy.
  • A rare type of tumor in the pancreas called an insulinomacan also cause hypoglycemia in people who do not have diabetes. If you do suffer from episodes of hypoglycemia, it is wise to follow up with a visit to your doctor, to rule out the possibility of an insulinoma or another medical condition.

How Can You Manage Reactive Hypoglycemia?

There are several strategies that may help to prevent and prepare for episodes of reactive hypoglycemia, including:

  • Limit foods with a high sugar content, especially on an empty stomach. For example, eating a doughnut first thing in the morning can trigger a hypoglycemic episode.
  • Eat small, frequent meals and snacks that include fiber and protein.
  • Eat a varied, high fiber diet, with adequate servings of protein, whole grain carbs and vegetables, fruits, and dairy foods
  • Carry pieces of hard candy with you, for those times when you feel your blood sugar dropping.

What to Do If You Are Having a Hypoglycemic Episode

If you experience a hypoglycemic episode, follow these steps:

  • Eat or drink something that is a fast sugar source, such as 4 oz of orange juice, 6-8 ounces of regular sweetened soda, a few pieces of hard candy, or sugar cubes. This should relieve the symptoms within 15 minutes. 
  • Avoid choosing chocolate as a sugar source. The fat in chocolate makes it absorb more slowly and it won't raise your blood sugar up as quickly as you need it too.
  • Make sure to eat a small balanced meal or snack after the symptoms are gone. For example, an apple with peanut butter or a turkey sandwich on whole grain bread. This will prevent another blood sugar spike and consequent drop.


National Institute of Diabetes and Digestive and Kidney Diseases. Low Blood Sugar (Hypoglycemia). 

Serive, F; Vella, A. Postprandial (reactive hypoglycemia). Up to Date. 

Continue Reading