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Cited by 50Diabetes Management and ResearchPancreatic function and diabetesNeurological and metabolic disorders

Reactive hypoglycemia

Hofeldt, Fred D.·1975·Metabolism
DOI 10.1016/0026-0495(75)90156-0
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Abstract

The hypoglycemoses include a large category of distinctly unique entities. Guidelines for a clinical, physiological approach to these disorders is presented. Within this diagnostic spectrum of hypoglycemia lies the reactive hypoglycemic disorders that are characterized by their postprandial onset, adrenergic mediated symptoms, and relatively benign causes. The spectrum of reactive hypoglycemia includes early alimentary-reactive hypoglycemia, late diabetic-reactive hypoglycemia, hormonal deficiency states, and idiopathic hypoglycemia. A new postprandial hypoglycemic disorder, fructose 1-6 diphosphatase, can be added to this list. The frequent sampling of blood-glucose values in the postprandial state will frequently lead to the finding of a biochemically low blood-glucose value of below 50 ml/100 ml, and these individuals show no hypothalamic-pituitary-adrenal stress to the low blood sugar and do not manifest adrenergic symptoms. Their low blood-glucose value simply reflects the transition in intermediary metabolism between the fed and fasting state and provides a biochemical marker of this event. We refer to this asymptomatic biochemical event as transitional low blood-glucose state. It has no clinical implication and may frequently be confused with the bona fide reactive hypoglycemic disorders. Using a symptomatic, counter-regulatory model to define hypoglycemia as a bona fide disorder, findings are presented in patients with the varying types of reactive hypoglycemia, and their results are compared to normal controls and to a weight-matched and disease patient controls. Abnormalities in insulin secretion are discussed as relating to the pathophysiology causal in the hypoglycemia. An approach to therapy is presented based upon the classification of the patient as to the type of hypoglycemia and their abnormalities in insulin secretion.

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125 of 125 references verified0 citation errors · 0 not checkable

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Cites

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Research works printed but not linked: 23

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  21. Smelo, 1966, Treatment of functional hypoglycemia as early manifestation of diabetes mellitus, Mod Treat, 3, 342
  22. Hofeldt FD, Lufkin EG, Hull SF, Davis JW, Levin S, Forsham PH: Alimentary reactive hypoglycemia: Effects of DBI and Dilantin(R) on insulin secretion Milit Med (in press)
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Authors
Hofeldt, F. D.
Affiliations
Fitzsimons Army Medical Center (US)
Corresponding author
Hofeldt, Fred D.
Venue
Metabolism
Publisher
Elsevier BV
Published
1975-10
Volume
24
Issue
10
Pages
1193-1208
ISSN
0026-0495 (ISSN-L)
DOI
10.1016/0026-0495(75)90156-0
OpenAlex
W4211015449
Semantic Scholar
c17742c53f39783adc066e2fc51d7964b83e5739
Cited by
50
References
125
Citations by year
2026: 3 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2016: 1 · 2014: 1
FWCI
0.73
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
Keywords
reactive hypoglycemia, hypoglycemia, postprandial hypoglycemia, idiopathic hypoglycemia, fructose-1,6-bisphosphatase deficiency, counterregulatory hormones, insulin secretion, adrenergic symptoms
MeSH terms
Blood Glucose, Fasting, Glucose, Homeostasis, Humans, Hypoglycemia, Insulin

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