A doctor in Tainan warned about the dangers of reactive hypoglycemia, or post-meal low blood sugar, after a 58-year-old woman developed symptoms following a buffet lunch.
The woman, surnamed Liu (劉), developed symptoms including shaky hands, dizziness, palpitations and cold sweat shortly after eating, said Wang Wei-hsin (王維新), a family physician who treated Liu at Tainan Municipal Hospital.
Liu said that she had not taken medication to lower her blood sugar, yet Wang found that her blood sugar level was 60 milligrams per deciliter (mg/dL), she said.
Lower blood sugar usually occurs before people eat and can be caused by delayed meal times, too much exercising, dieting, eating too little, or, among diabetics, if they take too much medication, such as insulin, to lower their blood sugar, Wang said.
However, reactive hypoglycemia typically affects people with insulin resistance or mild cases of type 2 diabetes, she said, adding that symptoms tend to emerge within four hours of eating.
In the early stages of type 2 diabetes, the beta cells in the pancreas retain the ability to produce insulin, but they respond slowly to blood sugar levels, she said.
The pancreas rushes to secrete insulin only after the after-meal rise in blood sugar levels has already begun to subside, leading to an overproduction of insulin and, as a result, blood sugar levels lower than normal, she said.
Liu, who has a family history of diabetes, was diagnosed with mild diabetes.
When a patient’s blood sugar level drops below 70mg/dL and they experience symptoms such as tremors, blurred vision or slurred speech, they should eat a piece of candy, or drink sugared water or sweetened juice immediately, Wang said.
Milk, chocolate and other foods that contain protein and fat are not the best options, because they raise blood sugar levels more slowly, she said.
Patients with reactive hypoglycemia should eat smaller portions, but more frequently, avoid waiting too long between meals and consume carbohydrates that are high in fiber or low on the glycemic index, such as brown rice, oatmeal and vegetables, she said.
They should also maintain a balanced and varied diet, and exercise more to boost their insulin sensitivity, she added.
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