What is Reactive Hypoglycemia?
Excessive sweating, palpitations, tremors in the hands, loss of concentration, irritability, nausea, and excessive hunger occur as a result of low blood sugar following a hunger that occurs 3-5 hours after a meal rich in carbohydrates. If these complaints improve immediately after carbohydrate intake, this picture is called “reactive hypoglycemia”.
How does Reactive Hypoglycemia develop?
Irregularity in sugar metabolism is the most common cause of reactive hypoglycemia. Normally, the sugar we take with food is carried to the cell door, thanks to the hormone called insulin, it enters the cell, turns into energy by burning, and thus life continues. Reactive hypoglycemia is generally associated with insulin resistance. The body begins to secrete more insulin than it should in order to overcome the developing insulin resistance and to bring sugar into the cell. Thanks to the more secreted insulin, the sugar level stays within normal limits immediately after meals or a carbohydrate food intake. Since these normal values are only possible with the passage of large amounts of insulin into the blood, high insulin in the blood will cause a decrease in sugar in the following hours. The more carbohydrates a person takes at once, the more insulin will be secreted.
When does Reactive Hypoglycemia occur?
Reactive hypoglycemia also occurs in the prediabetic period, in cases where gastric emptying time is shortened, in duodenal ulcer, and after gastrojejunostomy operations. They reveal the same picture in diseases that accelerate gastrointestinal motility, such as hyperthyroidism. Idiopathic reactive hypoglycemia is a very common picture. When we review the symptoms in this picture, which occurs 3-5 hours after a meal rich in refined carbohydrates, hypoglycemia may resemble cardiological and psychiatric diseases, and hypoglycemia should be investigated in such cases.
How is the diagnosis of Reactive Hypoglycemia made?
There are two important tests used in the diagnosis:
Prolonged fasting test
Oral glucose tolerance test
Normally, blood sugar drops during prolonged fasting. Insulin also follows this decline. At the 72nd hour of fasting, blood sugar is around 45 mg/dl and remains constant here. While glycemia is 30 mg-40 mg/dl, insulin should be practically undetectable (unmeasurable).
The oral glucose tolerance test is used to detect reactive hypoglycemia. It is argued that it is not physiological. However, there is no test that we can replace yet. However, in the oral glucose tolerance test lasting 6 hours, the presence of complaints during the test and a decrease in glycemia below 55 mg/dl are important in the diagnosis.
What are the diseases associated with Reactive Hypoglycemia?
It is frequently associated with hypertension, migraine, arrhythmia, food allergy, and low risk reactive hypoglycemia.
How is Reactive Hypoglycemia treated?
Treated with diet and exercise. A low glycemic index diet can be given. Medicines used for insulin resistance can reduce complaints.
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