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Suggest Treatment For Reactive Hypoglycemia

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Posted on Fri, 3 Jul 2015
Question: I don't have diabetes. I just had my annual blood tests and my A1C was 4.0. The blood sugar high I had last night was very rare. My blood sugar is usually very normal after eating and then drops to low in the 30s to 40s range. I have tried the several small meals but because I. already diagnosed with Reactive Hypoglycemia, it just gave me more opportunities for hypoglycemia episodes, the more meals I ate. My mom is the only one in my family who has been diagnosed with diabetes. I always feel stuck as to what to do. Doctors so far have been unable to help other than modifying my diet. Even when I eat like I am suppose to, I end up with very low sugar levels 30 to 45 minutes after finishing a meal. For example, last night when I posted my
question my sugar was in the 200s (I don't remember the exact number). Exactly 37 minutes later it was 49. The symptoms of the high, drop and then low make me feel horrible. Together they feel like a major panic attack! And after, I can hardly stay awake. I monitor my sugar regularly and always carry glucose tabs but wonder if I should be doing more.
doctor
Answered by Dr. Shehzad Topiwala (6 hours later)
Brief Answer:
Hypoglycemia

Detailed Answer:
I am sorry to learn about your challenges with low blood glucose reactions. They can be terrifying.

Reactive hypoglycemia tends to occur in those prone to developing diabetes or in early stages of type 2 diabetes.

It can occur in individuals without these risk factors too.

Just make sure you dont have a rare condition called Insulinoma. Chances are very small because that typically results in fasting low sugar episodes, although that is not always the case.

The best way to get comprehensively evaluated for this is to see an endocrinologist who may consider performing a 48 hour prolonged fast test.

When I see someone like you in my practice I order the following tests in addition to a thorough physical examination:

CBC
CMP
TSH
Free T4
Serum Cortisol at 8 am

None of these tests require fasting.

Once the diagnosis is certain, and indeed it could well turn out to be Reactive Hypoglycemia, treatment can be planned accordingly.

Small frequent meals with minimal refined carbohydrates is key but clearly it has not helped you.
Ask your endocrinologist if a medication called Acarbose can be considered for you. it has been shown to be effective in improving the symptoms of reactive hypoglycemia






Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (2 hours later)
Thank you for all of your responses!
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Follow up

Detailed Answer:
You are welcome. I hope you find some relief in the problematic condition you have
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest Treatment For Reactive Hypoglycemia

Brief Answer: Hypoglycemia Detailed Answer: I am sorry to learn about your challenges with low blood glucose reactions. They can be terrifying. Reactive hypoglycemia tends to occur in those prone to developing diabetes or in early stages of type 2 diabetes. It can occur in individuals without these risk factors too. Just make sure you dont have a rare condition called Insulinoma. Chances are very small because that typically results in fasting low sugar episodes, although that is not always the case. The best way to get comprehensively evaluated for this is to see an endocrinologist who may consider performing a 48 hour prolonged fast test. When I see someone like you in my practice I order the following tests in addition to a thorough physical examination: CBC CMP TSH Free T4 Serum Cortisol at 8 am None of these tests require fasting. Once the diagnosis is certain, and indeed it could well turn out to be Reactive Hypoglycemia, treatment can be planned accordingly. Small frequent meals with minimal refined carbohydrates is key but clearly it has not helped you. Ask your endocrinologist if a medication called Acarbose can be considered for you. it has been shown to be effective in improving the symptoms of reactive hypoglycemia