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Suggest Treatment For Reactive Hypoglycemia

Posted on Wed, 16 Jul 2014

Question: I have a extreme case of reactive hypoglycemia I was diagnosed in 2009 and have suffered ever since my current in your car knowledge is it to the p or other vital organs in my body from this diet long termtic ectomy I have found research on the internet that support this but I've also found a resource that says it doesn't even do anything to cure my condition I wanted to get another endocrinologists thoughts to let you know I'll help bad my condition is I cannot eat anything with carbs in it or else my blood sugar would drop within a few hours Tuco I have cut out all carbs in my diet and I am scared because I am afraid I'm going to do permanent damage to my heart or other vital organs in my body from this diet long-term I take acarbosea medicine that was given to me by my endo call a and it works fairly well

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Reactive hypoglycemia

Detailed Answer:
Sorry to learn about your condition.

Yes I agree reactive hypoglycemia can be frustrating to deal with. There are limited things that can be done for it. Acarbose is one of them in addition to dietary changes that you have already made.

I am sure you have seen a dietitian to help you make the right choices food-wise in terms of long acting carbohydrates.

Also be sure you do not have fasting hypoglycemia which can indicate the presence of other worrisome conditions like insulinoma

May I assume you do not have diabetes and are not on any medications for the same?

Have you had gastric bypass (bariatric) surgery for weight loss? The reason I ask is because sometimes a similar hypoglycemic reaction is seen in such individuals sometimes years after the surgery

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (7 hours later)

Those are great questions I do not have fasting hypoglycemia which is good and I have not had any surgeries I am 5'11 148 pounds in fairly good shape one and Okinawa just actually thought that it was a insulinoma for a few more on my pancreas I got a xray done and he said that he's Sol maybe something but didn't think it was so I'm wondering if I should get another one I thought that was a big maybe to put out there

Answered by Dr. Shehzad Topiwala (14 hours later)

Brief Answer:
Follow up

Detailed Answer:
If you are certain it is not fasting hypoglycemia and insulinoma ruled out then it is important to get the dose of acarbose right.

When I treat patients with such complaints, I start with 25 mg of acarbose and slowly go up to 25 three times daily with each major meal and if required based on symptom control go to even 50 to 100 mg three times daily.
This can cause stomach distress and gassiness though.

But I fully agree it can be challenging to manage this problem.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar