PMID- 33916952
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210502
IS  - 2075-4426 (Print)
IS  - 2075-4426 (Electronic)
IS  - 2075-4426 (Linking)
VI  - 11
IP  - 4
DP  - 2021 Apr 7
TI  - Metabolic Parameters in Patients with Suspected Reactive Hypoglycemia.
LID - 10.3390/jpm11040276 [doi]
LID - 276
AB  - BACKGROUND: It remains unclear whether reactive hypoglycemia (RH) is a disorder 
      caused by improper insulin secretion, result of eating habits that are not 
      nutritionally balanced or whether it is a psychosomatic disorder. The aim of this 
      study was to investigate metabolic parameters in patients admitted to the 
      hospital with suspected RH. METHODS: The study group (SG) included non-diabetic 
      individuals with symptoms consistent with RH. The control group (CG) included 
      individuals without hypoglycemic symptoms and any documented medical history of 
      metabolic disorders. In both groups the following investigations were performed: 
      fasting glucose and insulin levels, Homeostatic Model Assessment for Insulin 
      Resistance (HOMA-IR), 75 g five-hour Oral Glucose Tolerance Test (OGTT) with an 
      assessment of glucose and insulin and lipid profile evaluation. Additionally, 
      Mixed Meal Tolerance Test (MMTT) was performed in SG. Results from OGTT and MMTT 
      were analyzed in line with the non-standardized RH diagnostic criteria. RESULTS: 
      Forty subjects have been enrolled into SG. Twelve (30%) of those patients had 
      hypoglycemic symptoms and glucose level </=55 mg/dL during five-hour OGTT and have 
      been diagnosed with RH. Ten (25%) subjects manifested hypoglycemic like symptoms 
      without significant glucose decline. Patients with diagnosed RH had statistically 
      significantly lower mean glucose at first (92.1 +/- 37.9 mg/dL vs. 126.4 +/- 32.5 
      mg/dL; LSD test: p < 0.001) and second (65.6 +/- 19.3 mg/dL vs. 92.6 +/- 19.3 mg/dL; 
      LSD test: p < 0.001) hour of OGTT and insulin value (22.7 +/- 10.9 lU/mL vs. 43.4 +/- 
      35.0 lU/mL; LSD test: p < 0.001) at second hour of OGTT compared to the patients 
      who did not meet the criteria of RH. Seventeen (43%) subjects from SG reported 
      symptoms suggesting hypoglycemia during MMTT but none of them had glucose value 
      lower than </=55 mg/dL (68.7 +/- 4.7 mg/dL). From the entire lipid profile, only mean 
      total cholesterol value was significantly higher (p = 0.024) in SG in comparison 
      with CG but did not exceed standard reference range. CONCLUSIONS: No metabolic 
      disturbances have been observed in patients with diagnosed reactive hypoglycemia. 
      Hyperinsulinemia has not been associated with glycemic declines in patients with 
      this condition. Occurrence of pseudohypoglicemic symptoms and lower glucose value 
      was more common after ingestion of glucose itself rather than after ingestion of 
      a balanced meal. This could suggest an important role that nutritionally balanced 
      diet may play in maintaining correct glucose and insulin levels in the 
      postprandial period.
FAU - Hall, Marianna
AU  - Hall M
AUID- ORCID: 0000-0003-4127-7332
AD  - Department of Human Nutrition, Faculty of Health Sciences, Medical University of 
      Warsaw, 01-445 Warsaw, Poland.
AD  - Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical 
      Hospital of the Ministry of Internal Affairs and Administration in Warsaw, 02-507 
      Warsaw, Poland.
FAU - Walicka, Magdalena
AU  - Walicka M
AD  - Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical 
      Hospital of the Ministry of Internal Affairs and Administration in Warsaw, 02-507 
      Warsaw, Poland.
AD  - Department of Human Epigenetics, Mossakowski Medical Research Institute Polish 
      Academy of Sciences, 02-106 Warsaw, Poland.
FAU - Panczyk, Mariusz
AU  - Panczyk M
AUID- ORCID: 0000-0003-1830-2114
AD  - Department of Education and Research in Health Sciences, Faculty of Health 
      Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland.
FAU - Traczyk, Iwona
AU  - Traczyk I
AUID- ORCID: 0000-0001-7413-1212
AD  - Department of Human Nutrition, Faculty of Health Sciences, Medical University of 
      Warsaw, 01-445 Warsaw, Poland.
LA  - eng
PT  - Journal Article
DEP - 20210407
PL  - Switzerland
TA  - J Pers Med
JT  - Journal of personalized medicine
JID - 101602269
PMC - PMC8067537
OTO - NOTNLM
OT  - hyperinsulinemia
OT  - insulin resistance
OT  - reactive hypoglycemia
COIS- The authors declare no conflict of interest.
EDAT- 2021/05/01 06:00
MHDA- 2021/05/01 06:01
PMCR- 2021/04/07
CRDT- 2021/04/30 01:04
PHST- 2021/03/08 00:00 [received]
PHST- 2021/04/01 00:00 [revised]
PHST- 2021/04/04 00:00 [accepted]
PHST- 2021/04/30 01:04 [entrez]
PHST- 2021/05/01 06:00 [pubmed]
PHST- 2021/05/01 06:01 [medline]
PHST- 2021/04/07 00:00 [pmc-release]
AID - jpm11040276 [pii]
AID - jpm-11-00276 [pii]
AID - 10.3390/jpm11040276 [doi]
PST - epublish
SO  - J Pers Med. 2021 Apr 7;11(4):276. doi: 10.3390/jpm11040276.