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Non-Diabetic Hypoglycemia

Medically reviewed by Last updated on Sep 3, 2023.

What is non-diabetic hypoglycemia?

Non-diabetic hypoglycemia is a condition that causes the sugar (glucose) in your blood to drop too low. This can happen in people who do not have diabetes. The 2 types of non-diabetic hypoglycemia are fasting hypoglycemia and reactive hypoglycemia. Fasting hypoglycemia often happens after the person goes without food for 8 hours or longer. Reactive hypoglycemia usually happens about 2 to 4 hours after a meal. When your blood sugar level is low, your muscles and brain cells do not have enough energy to work well.

What causes non-diabetic hypoglycemia?

  • Fasting hypoglycemia:
    • Certain medicines or herbal supplements such as fenugreek, ginseng, or cinnamon
    • Alcohol
    • Exercise
    • Medical conditions such as liver disease, hypothyroidism, and tumors
    • Eating disorders or malnutrition
    • Stomach surgery or hemodialysis
  • Reactive hypoglycemia: The causes of reactive hypoglycemia may be unknown.
    • Hyperinsulinism
    • Meals high in refined carbohydrates such as white bread or foods high in sugar
    • Prediabetes
    • Any surgery of the digestive system

What are the signs and symptoms of non-diabetic hypoglycemia?

  • Blurred vision or changes in vision
  • Dizziness, lightheadedness, or shakiness
  • Fatigue and weakness
  • Fast or pounding heartbeat
  • Sweating more than usual
  • Headache
  • Nausea or hunger
  • Anxiety, Irritability, or confusion

How is non-diabetic hypoglycemia diagnosed?

  • Blood tests are done to measure your blood sugar levels. These tests may also be done to find the cause of your hypoglycemia.
  • Fasting tests may be done. You may have an overnight fasting test or a 72-hour fasting test. After you have fasted overnight, your blood sugar levels will be tested 2 times. For a 72-hour fasting test, you will not be given food for a period of up to 72 hours. During this time, healthcare providers will check to see if your blood sugar drops to a certain level.
  • An oral glucose tolerance test may be done. After you have fasted for 8 hours, your blood sugar level is tested. You are then given a glucose drink. Your blood sugar level is checked after 1 hour and again after 2 hours. Healthcare providers look at how much your blood sugar level increases from the first check.

How is non-diabetic hypoglycemia treated?

  • Keep food or drinks that contain carbohydrates on hand. Carbohydrates will raise your blood sugar level when you have hypoglycemia. Carbohydrates are found in bread, rice, cereal, fruits, juice, and milk. If you cannot eat or drink, your healthcare provider will give you glucose through an IV. An IV is a small tube placed in your vein. You may also receive a hormone called glucagon that helps raise your blood sugar level.
  • Treatment will depend on the cause of the hypoglycemia. For example, if a medicine you take is causing hypoglycemia, healthcare providers may change or stop giving you the medicine. If hypoglycemia is caused by low hormone levels, you may need to take hormones.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

How can I prevent hypoglycemia?

You may need to change what and when you eat to prevent low blood sugar levels. Follow the meal plan that you and the dietitian have planned. The following guidelines may help you keep your blood sugar levels under control.

  • Eat 5 to 6 small meals each day instead of 3 large meals. Eat the same amount of carbohydrate at meals and snacks each day. Most people need about 3 to 4 servings of carbohydrate at meals and 1 to 2 servings for snacks. Do not skip meals. Carbohydrate counting can be used plan your meals. Ask your healthcare provider or dietitian for information about carbohydrate counting.
  • Limit refined carbohydrates. Examples are white bread, pastries (pies and cakes), regular sodas, syrups, and candy.
  • Do not have drinks or foods that contain caffeine. Examples are coffee, tea, and certain types of sodas. Caffeine may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.
  • Limit or do not drink alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Do not drink alcohol on an empty stomach. Drink alcohol with meals to avoid hypoglycemia.
  • Include protein foods and vegetables in your meals. Some foods that are high in protein include beef, pork, fish, poultry (chicken and turkey), beans, and nuts. Eat a variety of vegetables with your meals.

When should I contact my healthcare provider?

  • You have blurred vision or vision changes.
  • You feel very tired and weak.
  • You are sweating more than usual for you.
  • You have a fast heartbeat.
  • You feel dizzy, lightheaded, and shaky.
  • You have questions about your condition or care.

When should I seek immediate care or call 911?

  • You have symptoms of hypoglycemia and cannot eat.
  • You have trouble thinking clearly.
  • You have a seizure or faint.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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