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Having reactive hypoglycemia. Need information on different types of hypoglycemia

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Orthopaedic Surgeon
Practicing since : 2011
Answered : 5146 Questions
I have had reactive hypoglycemia for over 50 years. I have come to the conclusion that there are 2 distinct types of reactive hypoglycemia. One type is related to insulin and the other type (mine) is related to the chemistry of the liver. One type needs small amounts of sugar and starch (insulin) the other type needs as little sugar and starch as possible (liver related). What do you think about my theory.
Posted Sun, 3 Jun 2012 in General Health
Answered by Dr. Aashish Raghu 2 hours later
Hi there.

Thanks for the query.

Reactive hypoglycemia is a condition where the symptoms of hypoglycemia occurs just after having a meal, These symptoms are dizziness, sweating, palpitations, nervousness, irritability, panic attack etc.

The theories are not well understood about the mechanism of this phenomenon but presently accepted theories are highly increased release of Insulin after a high carbohydrate meal or low Glucagon hormone levels in the body.

It is more commonly seen in those who have had surgery to stomach, hormonal disorders like hypothyroidism and adrenergic syndrome, bacterial infections of stomach etc.

Commonest cause could be Dumping syndrome where a high carbohydrate meal stimulates excessive Insulin secretion into the blood which reduces the blood sugar to very low levels. Also features of dehydration will be present.

Dumping syndrome has the following features after consuming high carbohydrate or high amount of food in a meal.

Avoid eating high carbohydrate meal as well as large amount of food at a time. Eat short frequent meals every 3 hours. Eat a balanced diet XXXXXXX in fresh fruits and XXXXXXX leafy vegetables. Drink 1-2 litres of water daily. Do daily brisk walking exercise for 40 minutes a day.

You find relief by eating less bulky meals which have less sugar and starch. The reason is probably because of Dumping syndrome as mentioned above.

Keep your blood sugar under control with proper diet, exercise and prescribed medication. Do regular monitoring of blood sugar levels.

I hope I have answered your query. I will be available to answer your follow up queries.


Above answer was peer-reviewed by
Follow-up: Having reactive hypoglycemia. Need information on different types of hypoglycemia 21 hours later

You are not giving my symptoms. I do have immediate fog in my brain but it takes many hours before I have low blood sugar and the symptoms you describe. It is the fact that the major problems occur many hours after I eat too much sugar and/or starch that made it very difficult for me (6 years) to find out that the problem was sugar related. When my glucose tolerance test lead to an immediate trouble standing up (quickly overcome) and then high (not very) blood sugar readings for 2+ hours followed by a precipitous drop in blood sugar (they did not run the test long enough to find out what it finally dropped to). I then had a mild shaking episode and no further problems. If I eat any significant sugar or starch I am subject to random low sugar events (mostly fatigue followed by shaking) and/or vaso-vagal (trouble standing up and fatigue) symptoms. The guess I have found is that my liver is having troubles absorbing and releasing sugar and uses adrenaline to overcome the problems (I have many other symptoms showing an overreaction to adrenalin) . I think I have heard of 2 other people with similar symptoms. I worry that I will be treated as a diabetic with hypoglycemia and the sugar they feed me could lead to my death. Do you know where I can find information about people with my symptoms and how can I get people not to assume I have insulin related hypoglycemia?
Answered by Dr. Aashish Raghu 3 hours later
Hi there.

Thanks for your reply.

The symptoms of fatigue and brain fog are because of initial hyperglycemia due to the intake of high carbohydrate meal. Also certain disorder with Insulin can be suspected in this case.

Later you possibly develop hypoglycemic symptoms like shaking episode, vasovagal trouble as well.

Insulin hormone is released from the Pancreas so you need to get it evaluated by an Endocrinologist.

Diabetes mellitus can also present in this fashion which is why it needs to be ruled out by an Endocrinologist.

Get a fasting blood sugar test done after an 8 hour complete fast. If it is more than 126mg/dL then you have Diabetes. Also get post-prandial blood sugar levels estimated for the same.

Kindly follow above mentioned precautions for better health.

Consult a leading Endocrinologist to evaluate your pancreatic function, rule out Diabetes and other causes of this problem as mentioned above.

I hope I have answered your query.

Wishing good health.


Above answer was peer-reviewed by
Follow-up: Having reactive hypoglycemia. Need information on different types of hypoglycemia 9 hours later

When I was out of control (did not eat an XXXXXXX diet) I had fasting blood sugar readings of 70. When I am in control my fasting blood sugar is 90. My test for average blood sugar showed that my blood sugar was below normal when I was out of control and now shows completely normal. I completely disagree with you. My symptoms are not what you would expect from insulin problems. I worry that doctors with your outlook could lead to my death. I have found after over 50 years that what I need to do is eat as little sugar and starch as possible.
XXXXXXX Grossbard
XXXXXXX Grossbard
Answered by Dr. Aashish Raghu 36 minutes later

Thanks for the reply.

Since your Fssting blood sugar are in normal limits you could be suffering from possible autonomic dysfunction or problems with maintaining normal blood pressure.

The symptoms of hypoglycemia can match those of low blood pressure as well.

Kindly get your blood pressure and heart evaluated by your Doctor to rule out this problem as well.

Get tested for hormonal problems like Thyroid hormone problems as well.

Kindly follow up with me on your progress.

Wishing good health.


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