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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Hypoglycemia and reactive hypoglycemia

Hypoglycemia and reactive hypoglycemia

Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose). Hypoglycemia is commonly associated with diabetes mellitus. However, there are variety of conditions, many of them rare, can cause low blood sugar. Hypoglycemia is not a disease by itself; it's an indicator of a health problem.



Diabetes mellitus

Medications- antidiabetic medications (sulfonyl ureas, Metformin and others), Quinine, Gatifloxacin, and others

Excessive alcohol consumption

Critical illness- drug induced hepatitis, anorexia nervosa

Pancreatic tumors- Insulinoma

Endocrine disorders- disorders of adrenal and pituitary glands

Signs and symptoms

  • Confusion
  • Disorientation
  • Dizziness
  • Blurring of vision
  • Double vision
  • Loss of consciousness
  • Seizures
  • Tremors
  • Palpitations
  • Sweating
  • Anxiety
  • Hunger

Tests and diagnosis

  • Signs and symptoms
  • Low blood glucose levels
  • Correction of signs and symptoms with intravenous dextrose  


Brain needs glucose to function. It can utilize only glucose for energy source as it cannot utilize fatty acids or ketone bodies.

It’s must to recognize the signs and symptoms as early as possible because untreated hypoglycemia can result in loss of consciousness, seizures, and even death.


  • If you have diabetes – To take regular antidiabetic medications, not to skip meals after taking antidiabetic medications or insulin
  • If not diabetic - recurring episodes of hypoglycemia, eating frequent small meals throughout the day may keep your blood sugar levels from getting too low.


  • Early symptoms of hypoglycemia usually treated by consuming sugar, such as eating candy, drinking fruit juice or taking glucose tablets to raise your blood sugar level.
  • If the symptoms are more severe, impairing the ability to take sugar by mouth, you may need intravenous Dextrose or an injection of glucagon.
  • A tumor in your pancreas is usually treated by surgical removal.
  • Nesidioblastosis, enlargement of the pancreatic cells that make insulin, is treated by partial removal of the pancreas.

Reactive hypoglycemia

Reactive hypoglycemia is low blood glucose that occurs after a meal, usually one to three hours after eating. Often, the cause of reactive hypoglycemia isn't clear.

It’s due to hormone epinephrine, glucagon deficiency, and hyperinsulinemia

Signs and symptoms

  • Dizziness
  • Shakiness
  • Clumsiness
  • Sweating
  • Confusion
  • Hunger


  • Reactive hypoglycemia usually doesn't require treatment
  • Eat small frequent meals and snacks throughout the day, no more than three hours apart
  • Eat high-fiber rich foods
  • Avoid or limit sugary foods, especially on an empty stomach
  • Include physical activity as a daily routine