Reactive hypoglycemia – an interdisciplinary approach of the disease of XXI Century

Hall, Marianna; Walicka, Magdalena; Traczyk, Iwona

doi:10.36740/wlek202002134

Cited by 4 publications

(2 citation statements)

References 56 publications

(65 reference statements)

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“… 3 But, clinically, we found that some nondiabetic patients often come to the clinic for tachycardia, cold sweats, hunger, tremor and other autonomic nervous symptoms 3–4 hours after a meal, that is, at 10:00 am and 3:00 pm. This kind of hypoglycemia is called reactive hypoglycemia (RH), 4 which may be due to gastrointestinal dysfunction or insufficiency that leads to relative insulin secretion or increased insulin sensitivity, including some idiopathic functional hypoglycemia, often has no organic lesions; it occurs 2–5 hours after eating and does not easily attract attention but is a great hazard. Many daily activities are often disturbed by this type of hypoglycemic event, which is related to emotional ups and downs, irritability, and increased risk of falls, motor vehicle accidents, hospitalization and sudden death.…”

Section: Introductionmentioning

confidence: 99%

<p>Identification of Reactive Hypoglycemia with Different Basic BMI and Its Causes by Prolonged Oral Glucose Tolerance Test</p>

Lv¹,

Fang²,

Wen-qing³

et al. 2020

DMSO

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Purpose: To identify the population susceptible to reactive hypoglycemia and explain the possible reasons for their susceptibility. Methods: Ninety-four patients were divided into normal weight, overweight and obese groups before a 75-gram prolonged oral glucose tolerance test (POGTT). The incidence of reactive hypoglycemia (blood glucose ≤3.1 mmol/L or 55 mg/dL at points of 0-4 hours) was compared among three groups, and blood glucose and insulin levels were monitored simultaneously from 0-4 hours to assess the level of insulin resistance and insulin sensitivity. Furthermore, the degree of insulin resistance among three groups and within each subgroup (whether hypoglycemia events occurred) was compared. Results: Among the three groups, the incidence of hypoglycemia was significantly different at 3 (P=0.033) and 4 hours (P=0.020). At 4 hours, the incidence of reactive hypoglycemia in the obese group was approximately 3 times that in the normal weight group. The insulin level in obese group at 4 hours was nearly 4 times higher than that in normal group, and the same result also exists in the same subgroup of different groups. In addition, the hypoglycemia subgroup of obese group had higher insulin level than non-hypoglycemia (P=0.000). The homeostasis model assessment of insulin resistance index increased with increasing BMI among the three groups (P=0.000), while the Matsuda index decreased (P=0.000). The comparison of the homeostasis model assessment of insulin resistance index between subgroups in each group showed that the P values were 0.021, 0.038 and 0.085, successively, and the P values for the Matsuda index were 0.019, 0.013 and 0.119, respectively. Conclusion: Obese people has higher rate of reactive hypoglycemia than other groups in POGTT, in which insulin resistance may play an important role. But patients who are evaluated for reactive hypoglycemia need to be observed for at least 3 or 4 hours.

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Section: Introductionmentioning

confidence: 99%

<p>Identification of Reactive Hypoglycemia with Different Basic BMI and Its Causes by Prolonged Oral Glucose Tolerance Test</p>

Lv¹,

Fang²,

Wen-qing³

et al. 2020

DMSO

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show abstract

“…Although this condition has been identified in the early 20th century, until now there has been lack of its complete etiology and pathogenesis [ 4 ]. It is not uncommon that the patients who present with symptoms attributed to hypoglycemia have no glucose decline [ 5 ]. Their symptoms may occur in the postprandial period, but the frequency of those warning signs does not have a fully interpretable pattern.…”

Section: Introductionmentioning

confidence: 99%

Assessing Long-Term Impact of Dietary Interventions on Occurrence of Symptoms Consistent with Hypoglycemia in Patients without Diabetes: A One-Year Follow-Up Study

et al. 2022

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Background: A well-balanced nutritional diet pattern has a significant role in the management of diet-related disorders. Currently, there are no specific dietary guidelines to refer to when advising non-diabetic patients with symptoms attributed to hypoglycemia in the postprandial period or patients with confirmed reactive hypoglycemia (RH). The aim of this study was to investigate the impact of the dietary interventions, and their sustained outcome, on the severity of hypoglycemic-like symptoms occurring in non-diabetic patients. Methods: The study group included forty non-diabetic individuals with symptoms consistent with RH. At the baseline, each patient underwent RH diagnosis and complex dietary evaluation. Over a period of six months, each patient had four appointments with a dietitian. Two sessions were focused on a dietary education about low glycemic index diet (LGID) and Mediterranean diet (MD). The said diets were to be followed for a period of three months, with two additional dietary check-ups. Once dietary supervision was completed, patients had no imposed dietary patterns. The final follow-up appointment took place twelve months later and that is when each patient underwent a detailed assessment of their current dietary habits and evaluation of the frequency of symptoms consistent with hypoglycemia. Results: There was a statistically significant reduction in the severity in eight out of the ten analyzed hypoglycemic-like symptoms after the dietary interventions. The most significant change was observed in the following symptoms: hunger (η2 = 0.66), impaired concentration (η2 = 0.61), hand tremor (η2 = 0.55), and fatigue (η2 = 0.51). The outcomes were comparable for both recommended diets, the LGID and the MD. The reduction in hypoglycemic-like symptoms continued after the twelve-month period. The individualized dietary counselling significantly improved the patients’ eating habits in comparison to those present prior to intervention in terms of healthy diet index (F(2,78) = 27.30, p < 0.001, η2 = 0.41, 90%CI [0.26; 0.51]) and unhealthy diet index (F(2,78) = 433.39, p < 0.001, η2 = 0.91, 90%CI [0.89; 0.93]). Conclusions: Healthy modifications in dietary habits may improve patient’s well-being and reduce the severity of their postprandial symptoms attributed to hypoglycemia. Therefore, dietary intervention focused on appropriate nutritional management combined with follow-up consultations may be a beneficial step towards comprehensive treatment of non-diabetic patients who present with hypoglycemic-like symptoms in the postprandial period.

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Nutritional guidelines for the management of insulin resistance

Muscogiuri

Barrea

Caprio

et al. 2021

Critical Reviews in Food Science and Nutrition

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Reactive hypoglycemia – an interdisciplinary approach of the disease of XXI Century

Cited by 4 publications

References 56 publications

<p>Identification of Reactive Hypoglycemia with Different Basic BMI and Its Causes by Prolonged Oral Glucose Tolerance Test</p>

<p>Identification of Reactive Hypoglycemia with Different Basic BMI and Its Causes by Prolonged Oral Glucose Tolerance Test</p>

Assessing Long-Term Impact of Dietary Interventions on Occurrence of Symptoms Consistent with Hypoglycemia in Patients without Diabetes: A One-Year Follow-Up Study

Nutritional guidelines for the management of insulin resistance

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