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General Practice 2023

Reactive hypoglycemia: what é, symptoms and how é The diet

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Reactive hypoglycemia: what é, symptoms and how é The diet
Reactive hypoglycemia: what é, symptoms and how é The diet

Reactive hypoglycemia, or postprandial hypoglycemia, is a condition characterized by a decrease in blood glucose levels up to 4 hours after a meal, and is also accompanied by typical symptoms of hypoglycemia, such as headache, tremors and dizziness.

This condition is often not diagnosed correctly, 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 diagnosed correctly so that its cause can be investigated and the appropriate treatment can be indicated.

Symptoms of reactive hypoglycemia

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, being the main:

  • Headache;
  • Hunger;
  • Tremors;
  • Sickness;
  • Cold sweat;
  • Dizziness;
  • Tiredness;
  • Drowsy or agitation;
  • Palpitations;
  • Difficulty thinking.

For reactive hypoglycemia to be confirmed, it is necessary that in addition to the symptoms, the person has low amounts of circulating blood glucose after a meal and that an improvement in symptoms is observed after consumption of sugary foods.Identifying the cause is important so that treatment can be initiated, which is established by the endocrinologist according to the cause.

Main causes

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 excess production of insulin by the pancreas, with a rapid and excessive decrease in the amount of circulating glucose. Learn more about insulinoma.

How the diagnosis is made

Because the symptoms of reactive hypoglycemia are the same as those of common hypoglycemia, the diagnosis is often made wrong. Therefore, to make the diagnosis of postprandial hypoglycemia, the Whipple triad must be considered, in which the person must present the following factors for the diagnosis to be concluded:

  • Symptoms of hypoglycemia;
  • Blood glucose concentration measured in the laboratory below 50 mg/dL;
  • Improvement of symptoms after consuming carbohydrates.

In order to have a better interpretation of the symptoms and the values ​​obtained, it is recommended that in case of investigation of reactive hypoglycemia, the person who has symptoms goes to the laboratory and blood is collected after the meal and stay in place for about 5 hours. This is because the improvement of hypoglycemia symptoms should also be observed after carbohydrate consumption, which should happen after collection.

Thus, if low circulating glucose concentrations are found in the blood test and symptoms improve after carbohydrate consumption, postprandial hypoglycemia is conclusive, and investigation is recommended so that the most appropriate treatment can be initiated.

Diet for reactive hypoglycemia

Food is an important part of the treatment of reactive hypoglycemia, as it is essential that blood sugar levels are kept constant, and it is recommended that meals be eaten with intervals of 2 to 3 hours between each one.

It is recommended to give preference to foods rich in fiber, such as whole grains, vegetables and fruits, in addition to foods rich in proteins such as lean meat, fish and eggs and complex carbohydrates such as wholegrain bread, rice and pasta, and the whole version of these foods also has more fiber.

For breakfast and snacks, preference should be given to foods with complex carbohydrates and a low glycemic index, such as whole-grain bread with fresh cheese or whole-grain 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, eggs or beans.

To avoid reactive hypoglycemia crises, you should not eat foods rich in sugars and simple carbohydrates such as cakes, cookies, chocolates, sweets, soft drinks, refined foods such as white bread. It is also important to exclude alcoholic beverages from food.

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