What to Know About Reactive Hypoglycemia

Can You be Hypoglycemic Without Having Diabetes?

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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 after they eat a meal (within four hours of eating). Also known as postprandial hypoglycemia, it occurs within four hours after eating. Its causes are different than the hypoglycemia sometimes experienced by people who have diabetes, although the symptoms of both kinds of hypoglycemia are the same.

Symptoms of 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
  • Lack of coordination
  • Drowsiness or confusion
  • Headache
  • Dizziness
  • Double vision
  • Convulsions or unconsciousness

Note that you could be having these symptoms without it being reactive hypoglycemia. To properly identify the cause of your symptoms it's important to go to your healthcare provider for an evaluation.

What is the cause of reactive hypoglycemia?

The exact cause of reactive hypoglycemia is still unknown, 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.

How to 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.
  • 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 orange juice, regular soda, a few pieces of hard candy, or sugar cubes. This should relieve the symptoms within 15 minutes. Here is a more complete list of fast-acting carbohydrates.
  • 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 after the symptoms are gone. This will prevent another blood sugar spike and consequent drop.

*A rare type of tumor, called an insulinoma, in the pancreas can 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.


(2008, Oct.) National Diabetes Information Clearinghouse (NDIC). Retrieved January 27, 2009, from Hypoglycemia in People who do not Have Diabetes Web site: http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/#nodiabetes

de Souza M.D., Jose C. Two cases of Hypoglycemia. American College of Physicians, Retrieved Jan 27, 2009, from http://www.acponline.org/about_acp/chapters/mt/mtg06_desouza.pdf

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