What is Postprandial Hypoglycemia?

Postprandial hypoglycemia is a drop in blood glucose that occurs after eating a meal. Also known as reactive hypoglycemia, this form of low blood sugar is frequently seen in individuals who have undergone an invasive procedure to alter their digestive system, such as gastric bypass surgery. Treatment for postprandial hypoglycemia is usually dependent on the severity of symptom presentation and generally involves restoring one’s blood glucose to an appropriate level with the administration of a sugary substance, such as soda or fruit juice.

In cases of reactive hypoglycemia, a drop in blood sugar levels occurs following a meal. For some reason, insulin production following a meal skyrockets and introduces too much of the hormone into one’s bloodstream. The dispersion of glucose to the body's various cells is thrown into overdrive depleting the amount of blood sugar available. The liver is unable to compensate for the depletion of glucose, leading to a continued flood of insulin into a system that doesn't require its mediation. The result is an overabundance of insulin in a system that possesses no glucose for the hormone to regulate, leaving the body in a hypoglycemic state.

Individuals most often develop postprandial hypoglycemia when their digestive function has been disrupted due to surgery. In some situations, individuals may develop this form of hypoglycemia in response to impaired glucose tolerance or being overmedicated for an existing diabetic condition. The inappropriate administration of hypoglycemic treatment may also trigger a postprandial hypoglycemic episode.

Postprandial hypoglycemia is a progressive condition that is fairly easy to diagnose since the trigger for the drop in blood sugar is usually obvious. Considering a postprandial hypoglycemic episode is unlikely to occur while sitting in the physician's office, some individuals will opt to keep a written record of their experiences so they may accurately describe them during a consultation. A battery of blood tests is generally administered to evaluate an individual’s blood glucose levels over an extended period of time. Some situations may require that the individual fast prior to testing so an accurate reading may be taken.

Individuals with postprandial hypoglycemia will generally present with symptoms characteristic to any other form of hypoglycemia. The most common symptoms include feelings of hunger, lethargy and physical weakness. Symptomatic individuals may also experience profuse sweating, elevated heart rate and tremors during a hypoglycemic episode.

As the body begins the digestion process, it is not uncommon for individuals with this condition to suddenly appear pale or experience blurred vision or anxiety. More severe symptom presentations may include impaired cognition and erratic or uncharacteristic behavior. If symptoms are ignored and allowed to progress, hypoglycemic individuals may experience a seizure or lose consciousness; both situations have the potential to be life-threatening.

As with any hypoglycemic condition, treatment is centered on raising the individual’s blood glucose levels to a stable, normal level. Oftentimes, sugary items may be given to the person to eat or drink, including candy, soda, or fruit juice. Individuals with recurrent postprandial hypoglycemic episodes generally must implement dietary changes to help prevent future incidents.

Many hypoglycemic individuals are encouraged to work closely with a dietitian to design a meal plan that is conducive to promoting health and dietary balance, while at the same time preventing the recurrent onset of postprandial hypoglycemic symptoms. Severe presentations of this condition may necessitate the administration of injected glucagon to stabilize one’s blood glucose levels.