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Reactive hypoglycemia, postprandial hypoglycemia, or sugar crash is a term describing recurrent episodes of symptomatic hypoglycemia occurring within four hours [1] after a high carbohydrate meal in people with and without diabetes. [2]
Sulfonylureas have a greater risk of hypoglycemia but the risk is still only around 3% of patients who use them. [35] In patients who have a greater risk of low sugar, such as in the elderly and patients with kidney disease, the starting dose can be as low as 0.5 mg.
Prevention of type 2 diabetes can be achieved with both lifestyle changes and use of medication. [1] The American Diabetes Association categorizes people with prediabetes , who have glycemic levels higher than normal but do not meet criteria for diabetes, as a high-risk group.
Among people with diabetes, prevention starts with learning the signs and symptoms of hypoglycemia. [3] [2] Diabetes medications, like insulin, sulfonylureas, and biguanides can also be adjusted or stopped to prevent hypoglycemia. [3] [2] Frequent and routine blood glucose testing is recommended.
Hypoglycemia enjoys a popular position in the public's eye as a non-specific medical condition that frequently provides an explanation for the varied symptoms that occur in daily life. [3] These doctors cautioned against the over-diagnosis of reactive hypoglycemia. They said "both physicians and the public deserve major re-education."
For people with insulin-requiring diabetes, hypoglycemia is one of the recurrent hazards of treatment. It limits the achievability of normal glucoses with current treatment methods. Hypoglycemia is a true medical emergency, which requires prompt recognition and treatment to prevent organ and brain damage.