What Is Non-Diabetic Hypoglycemia?

When your blood sugar levels -- or blood glucose -- are too low, it's a condition called hypoglycemia. Glucose is the main way your body gets energy. You get glucose from what you eat and drink. If your levels are too low, you won't feel well.

Hypoglycemia is most common in people with diabetes. It can happen when they have issues with medicine, food, or exercise.

But sometimes people who don't have diabetes can also get low blood glucose. There are two kinds of non-diabetic hypoglycemia:

  • Reactive hypo glycemia, which happens a few hours after you eat a meal
  • Fasting hypo glycemia, which might be linked to medicine or a disease

What Causes Hypoglycemia When You Don't Have Diabetes?

The two types of hypoglycemia have different causes.

Reactive hypoglycemia usually happens within a few hours after you’ve eaten. It comes from having too much insulin in your blood. Possible causes include:

  • Having pre-diabetes or being more likely to have diabetes
  • Stomach surgery
  • Rare enzyme defects

Fasting hypoglycemia can have several causes:

What Are the Symptoms?

The symptoms may be different depending on how low your blood sugar goes. They usually include:

As hypoglycemia gets worse, symptoms might include:

How Is It Diagnosed?

To diagnose non-diabetic hypoglycemia, your doctor will do a physical exam and ask questions about any medicines you take. He’ll want to know all about your health and any history of diseases or stomach surgery.

He’ll check your blood glucose level, especially when you are having symptoms. He’ll also check to see if you feel better when your glucose goes back to a normal level.

If your doctor suspects hypoglycemia, you may have to fast until you start to have symptoms. He’ll test your blood glucose level at different times throughout the fast.

To check for reactive hypoglycemia, you may have to take a test called a mixed-meal tolerance test (MMTT). For this, you take a special drink that raises your blood glucose. The doctor will check your blood glucose levels over the next few hours.


What Are the Treatments?

Right away, you should reverse the low blood sugar by eating or drinking 15 to 20 grams of carbohydrates. You can take juice, hard candy, or glucose tablets. This will usually help your symptoms go away. Check your blood sugar again in 15 minutes and treat every 15 minutes if levels are still low. Call 911 if you don’t feel well or if you can’t get your blood sugar back up.

For severe symptoms -- passing out, seizures, or confusion -- call 911 right away. If you have serious attacks, ask your doctor if you should keep a home glucagon kit. This hormone made in your pancreas causes your liver to release sugar. The kid contains a little bottle (the doctor will call it a vial) and a syringe to inject yourself with it. People you’re with -- loved ones or caregivers -- should know how to give you the injection.

For a long-term solution, how you treat hypoglycemia depends on what's causing it. If a medicine triggers your low blood sugar, you may need to change it. If a tumor is to blame, you may need surgery.

Ask your doctor if you need to adjust what you eat or how much you exercise. Diet changes like these might help:

  • Eat small meals and snacks every few hours.
  • Include a broad variety of foods, including protein, fatty, and high-fiber foods.
  • Don't eat a lot of high-sugar foods.

Can You Prevent It?

You can make some easy changes that will help keep your blood sugar steady:

  • Eat at regular times during the day.
  • Never skip meals. The risk for hypoglycemia is usually lower if you always keep a regular exercise level, too.
  • Cut back on food and drinks with caffeine.
  • Avoid alcohol.

Work with your doctor to figure out anything else that may be causing your symptoms.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on April 25, 2018



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Mayo Clinic: "Hypoglycemia."

Allina Health: “Non-diabetic Hypoglycemia."

Endotext: "Non-Diabetic Hypoglycemia."

UW Health: “Nutrition Management of Low Blood Sugar without Diabetes (Postprandial Syndrome and Reactive Hypoglycemia).”

Memorial Sloan Kettering Cancer Center: “How to Give an Emergency Glucagon Injection to Treat Low Blood Sugar.”

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