Reactive hypoglycemia, or postprandial hypoglycemia, is a condition characterized by a decrease in blood glucose levels up to 4 hours after a meal. It is also accompanied by typical symptoms of hypoglycemia, such as headache, tremors and dizziness.
This condition is often not correctly diagnosed, being considered just a situation of common hypoglycemia and that would be related to stress, anxiety, irritable bowel syndrome, migraine and food intolerances, for example. However, reactive hypoglycemia needs to be correctly diagnosed so that its cause can be investigated and the appropriate treatment indicated.
Symptoms of reactive hypoglycemia
The symptoms of reactive hypoglycemia are related to a decrease in the amount of glucose circulating in the blood and, therefore, the symptoms are the same as those of hypoglycemia resulting from the use of some medications or prolonged fasting, the main ones being:
- Cold sweat;
- Drowsiness or restlessness;
- Difficulty in reasoning.
In order for reactive hypoglycemia to be confirmed, it is necessary that, in addition to the symptoms, the person has low amounts of circulating glucose in the blood after a meal and that an improvement in symptoms is verified after consumption of sugary foods. Identifying the cause is important so that treatment can be started, which is established by the endocrinologist according to the cause.
Reactive hypoglycemia is a consequence of uncommon diseases and, therefore, the diagnosis of this condition is often wrong. The main causes of reactive hypoglycemia are hereditary fructose intolerance, post-bariatric surgery syndrome and insulinoma, which is a condition characterized by the excess production of insulin by the pancreas, with a rapid and excessive reduction in the amount of circulating glucose.
How is the diagnosis made
Because the symptoms of reactive hypoglycaemia are the same as those of common hypoglycaemia, the diagnosis is often misdiagnosed. Therefore, to make the diagnosis of postprandial hypoglycemia, the Whipple’s triad should be considered, in which the person must obligatorily present the following factors in order to complete the diagnosis:
- Hypoglycemia symptoms;
- Laboratory-measured blood glucose concentration of less than 50 mg/dL;
- Improvement of symptoms after carbohydrate consumption.
In order to have a better interpretation of the symptoms and the values obtained, it is recommended that, in the event that reactive hypoglycemia is investigated, the person with symptoms goes to the laboratory and that blood is collected after the meal and remains in place for about 5 hours. This is because the improvement of hypoglycemia symptoms after carbohydrate consumption, which should happen after collection, must also be observed.
Thus, if low concentrations of circulating glucose and improvement of symptoms after consumption of carbohydrates are verified in the blood test, it is conclusive of postprandial hypoglycemia, and investigation is recommended so that the most appropriate treatment can be started.
Diet for reactive hypoglycemia
Food is an important part of the treatment of reactive hypoglycemia, as it is essential that sugar levels are kept constant in the blood, and it is recommended that meals be taken 2-3 hours apart.
It is recommended to give preference to foods rich in fiber, such as whole grains, vegetables and fruits, as well as foods rich in proteins such as lean meat, fish and eggs and complex carbohydrates such as wholegrain bread, rice and pasta, with the whole version these foods also have more fiber.
For breakfast and snacks, preference should be given to foods with complex carbohydrates and a low glycemic index, such as wholegrain bread with fresh cheese or wholegrain toast with yogurt. At lunch and dinner, the dish should always have half with vegetables and the other half with rice, pasta or potatoes with meat, fish, egg or beans.
To avoid reactive hypoglycemia crises, you should not eat foods rich in sugars and simple carbohydrates such as cakes, biscuits, chocolates, sweets, soft drinks, refined foods such as white bread. It is also important to exclude alcoholic beverages from the diet.