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It is recommended that the term reactive hypoglycemia be reserved for the pattern of postprandial hypoglycemia which meets the Whipple criteria (symptoms correspond to measurably low glucose and are relieved by raising the glucose), and that the term idiopathic postprandial syndrome be used for similar patterns of symptoms where abnormally low ...
Blood sugar levels above 300 mg/dL can cause fatal reactions. Ketones will be very high (a magnitude higher than when eating a very low carbohydrate diet) initiating ketoacidosis. The Mayo Clinic recommends emergency room treatment above 300 mg/dL blood glucose. The most common cause of hyperglycemia is diabetes.
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.
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."
In the elderly, hypoglycemia can produce focal stroke-like effects or a hard-to-define malaise. [medical citation needed] The symptoms of a single person do tend to be similar from episode to episode. In the large majority of cases, hypoglycemia severe enough to cause seizures or unconsciousness can be reversed without obvious harm to the brain.
The GTT (glucose tolerance test) is of limited value in the diagnosis of reactive hypoglycemia, since normal levels do not preclude the diagnosis, abnormal levels do not prove that the patient's other symptoms are related to a demonstrated atypical OGTT, and many people without symptoms of reactive hypoglycemia may have the late low glucose. [19]
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