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Hypoglycemia Causes, Symptoms and Treatment

This sheet deals with so-called reactive (or reactive) hypoglycemia, which can affect people without diabetes. For more information on diabetes-related hypoglycemia, see our Diabetes factsheet.

From the point of view of medicine, the following 3 criteria must be met in an individual to be able to affirm that he has reaction hypoglycemia:

  • the energy sudden declines accompanied by nervousness, tremor, a compelling hunger or other symptoms;
  • glucose or “sugar” in the blood, less than 3.5 millimoles per liter (mmol / l) at the time when symptoms occur;
  • the disappearance of discomfort after taking sugar, such as a candy or fruit juice.

These criteria were established in the 1930s by an American surgeon interested in pancreatic disorders, .

The reactive hypoglycemia is a topic controversial. Many people consider that they suffer from hypoglycaemia, but do not meet all of their criteria. For example, they regularly go through times of fatigue, low energy and nervousness, but their blood sugar remains perfectly normal. Thus, in these cases, the doctor can not conclude to hypoglycemia.

There is no clear explanation of the origin of these “pseudo – hypoglycaemia”. A state of panic or an excess of stress could be in question. In addition, some people’s body may react more strongly to lower blood sugar levels.

In medicine, “true”hypoglycaemia – which meets the three criteria listed above – is usually diagnosed in people with glucose intolerance (a preliminary stage of diabetes), diabetes or other pancreatic disease. Stomach surgery can also cause hypoglycaemia, but it is rather rare.

That said, whether it is true hypoglycaemia or “pseudo-hypoglycemia”, the symptoms are controlled and prevented in the same way, thanks to various changes in eating habits.

Better understand blood sugar

The glucose provides organs their main source of energy. It comes from the digestion of sugarscontained in food. They are called carbohydrates, carbohydrates or carbohydrates. Desserts, fruits and cereal products (rice, pasta and breads) abound.

A blood glucose normal fasting (that is to say after 8 hours without food), to a non-diabetic person, is between 3.5 mmol / l and 7.0 mmol / l. After a meal, it can rise to 7.8 mmol / l. In between meals, the body must ensure that there is enough glucose circulating in the blood to provide a source of energy to the organs. It is the liver that provides this glucose, either by synthesizing it or by releasing the glucose that it stores in the form of glycogen . The muscles also contain glycogen, but it cannot be used to restore low blood glucose.

Blood glucose is controlled by several hormones. The insulin secreted after a meal lowers blood sugar, while glucagon, the growth hormone , the adrenaline and cortisol the drive up. All these hormones are finely adjusted so that the circulating glucose level is relatively constant, even in a fasting situation.

Who is affected?

People who suffer from hypoglycemia are usually women in their twenties or thirties. Since this condition is not considered a disease, there are no reliable statistics on the number of people affected.


Most of the time, reaction hypoglycaemia is mild and fades spontaneously or after ingestion of foods that provide glucose to the body. There is no serious consequence.

Diagnostic of hypoglycemia

Once the situation that triggers the symptoms is discovered, the doctor may ask the patient to measure their blood glucose before and after a symptomatic period.

People who have a blood glucose meter at their disposal can use it. Otherwise, the blood glucose is taken using a blotting paper test (Glucoval), offered in some private laboratories.

If the blood glucose is abnormal, the doctor conducts a complete health check to find the cause. When the doctor suspects that the person is suffering from glucose intolerance or diabetes, other blood glucose tests are undertaken.

Symptoms of hypoglycemia

The symptoms of reactive hypoglycemia usually occur 3 to 4 hours after a meal.

  • A sudden energy drop.
  • Nervousness, irritability and tremors.
  • Pallor of the face.
  • Sweats.
  • A headache.
  • Palpitations.
  • An imperious hunger.
  • A state of weakness.
  • Dizziness, drowsiness.
  • An inability to concentrate and an incoherent speech.

When the crisis occurs at night, it can cause:

  • Insomnia.
  • Night sweats.
  • Nightmares.
  • Fatigue, irritability and confusion when waking up.

Risk factors

  • The alcohol. Alcohol inhibits the mechanisms that release glucose from the liver. It can cause hypoglycaemia in fasting subjects suffering from malnutrition.
  • A prolonged physical activity and too intense.

Prevention of hypoglycemia

Why prevent?
Reaction hypoglycemia and “pseudo-hypoglycemia” may be related to several factors that are sometimes difficult to determine. Nevertheless, the symptoms of many people can be prevented by adopting a balanced lifestyle based on a varied and healthy diet, good stress management and regular exercise. These measures, of course, have the great advantage of improving overall health.
Basic preventive measures
A healthy diet

Diet is the most important element in preventing hypoglycemic attacks.

Physical activity

Exercise regularly, but in a moderate way, avoiding violent and intense exercises. Exercise improves the functioning of hormones that control blood sugar.

See our Fitness file.

Good stress management

Learn how to manage your stress, that is to say to find the origin and find solutions to feel more in control (reorganize your schedule, provide meals of the week, etc …). Regularly practicing certain forms of relaxation, such as relaxation exercises (deep breathing, progressive muscular relaxation, etc …), also helps to relieve stress.

It is sometimes noted that hypoglycemic attacks tend to be rarer or to disappear altogether during the holidays.

See our file Stress and anxiety.

Medical treatments for hypoglycemia

In case of symptoms of hypoglycemia, it may be useful to consult a doctor to get a checkup.

The hypoglycaemia caused by other diseases are generally settled by treating the causes: the removal of the tumor in cases of insulinoma (pancreatic tumor), by a change in medication, etc.

The majority of hypoglycaemia is treated by a reorganization of the diet. Consulting a nutritionist can be helpful.

Diet: the basis of treatment

The goal is to stabilize blood sugar. This prevents sudden drops in energy. Here are some recommendations:

  • Take 3 meals a day at regular times.
  • Have a snack between meals.
  • Limit consumption of foods high in concentrated or “fast” sugars: commercial cakes and biscuits, ice cream, jams, dried fruits (alone), etc.
  • Eat enough dietary fiber (25g to 38g per day).
  • Avoid drinking alcohol on an empty stomach. A glass of alcohol while eating is usually well tolerated.
  • Limit coffee and other drinks that contain caffeine because they lower blood sugar.

What to do in case of a hypoglycemia crisis

    • In case of pseudo-hypoglycemia: sit down, and then eat a source of sugar, for example a fruit, a piece of bread or a homemade muffin.
    • In case of true hypoglycemia, which meets the 3 criteria stated at the beginning of the card: sit down, then eat a source of concentrated sugar, for example a fruit juice or a candy.
  • In any case, it is good to take a protein snack about twenty minutes later, like a piece of cheese or some nuts.

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