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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.
Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of metformin, [17] [5] rosiglitazone, [18] or valsartan. [19] Lifestyle interventions are, however, more effective than metformin alone at preventing diabetes regardless of weight loss, [20] though evidence suggests that lifestyle interventions and metformin together can be effective ...
Glucose is the main source of energy for the brain, and a number of mechanisms are in place to prevent hypoglycemia and protect energy supply to the brain. [ 3 ] [ 17 ] The body can adjust insulin production and release, adjust glucose production by the liver , and adjust glucose use by the body.
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."
Recurrent mild hypoglycemia may fit a reactive hypoglycemia pattern, but this is also the peak age for idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to orthostatic hypotension or hyperventilation as often as demonstrable hypoglycemia. [citation needed] Insulin-induced hypoglycemia