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October 5, 2006

Hypoglycemia, Meal Planning, Food and Diet

Question from Battle Creek, Michigan, USA:

My four year old daughter was recently diagnosed with hypoglycemia by our regular pediatrician who referred us to a pediatric endocrinologist. She has symptoms (extremely lethargic, like a rag doll, pale, sweaty) of hypoglycemia with low readings on a home glucose monitor. Symptoms seem to appear around a reading of 50 mg/dl [2.8 mmol/L]. We have never had a reading below this. She had a three hour glucose tolerance test and the test was ended sooner than planned when symptoms started and she had a fingerprick reading of 50 mg/dl [2.8 mmol/L]. They drew the blood about 10 minutes later and it was up to 67 mg/dl [3.7 mmol/L]. We went to the pediatric endocrinologist who told us that they do not consider it hypoglycemia until you get readings in the 40s mg/dl [2.2 to 2.7 mmol/L] even if there are symptoms and the symptoms are relieved with juice. We took her to a learning hospital and they also indicated that they do not consider reactive hypoglycemia a valid medical condition, although many doctors do. Do some doctors not acknowledge reactive hypoglycemia? Should we treat this with diet as described on this site and not seek anymore professional help unless we have more ongoing problems? Should we see another endocrinologist?


There is no harm in using a well-balanced, healthy meal plan that avoids simple carbohydrates and relies on food at three hour intervals, meals or snacks which are high in protein/fat. This almost always resolves such problems of “reactive hypoglycemia” whether or not it is real and reproducible diagnosis or not. And, there are no side effects from such nutritious well balanced foods/snacks. If this does not work, and there is documented hypoglycemia with symptoms, then you should either go back and discuss with the first pediatric endocrinologist or seek a second consultation.