I have chronically lower blood sugar four hours after I eat. I have been diagnosed as “reactive hypoglycemic.” I get hypoglycemic symptoms when my blood sugar is in the 80s mg/dl [4.4 to 4.9 mmol/L]. Is this normal?

Sometimes the symptoms are more striking if there has been a large fall in blood sugar, even though you don’t reach historically low levels for the absolute blood sugar. Reactive hypoglycemia is not really normal. This is due simply to the idea people do not feel well with the problem. However, it does happen a fair amount. It is likely to occur when individuals eat a large carbohydrate meal that stimulates insulin production. The body does not brake the insulin secretion as well as it should. Therefore, as the blood sugars fall into the normal range, there is an overshoot into the low blood sugar range, before the blood sugar stabilizes back in the normal range. Treatment is usually dietary by eating small, frequent feedings during the days and avoidance of simple carbohydrates that markedly increase insulin secretion. It is generally benign and self-limited, although the duration is not specific.

JTL