The Reactive Hypoglycemia Test

There are a few tests your doctor might recommend you take to diagnose reactive hypoglycemia. As discussed in my article How To Get Diagnosed for Reactive Hypoglycemia, there really are only two ways this can be done (Hyperglucidic Breakfast Test and at Home). There are a couple of others your doctor might recommend. Here are their descriptions.

Hyperglucidic Breakfast Test

In this test a patient is given a meal of of bread (80 g), butter (10 g), jam, skimmed concentrated milk (80 ml), sugar (10g) and powdered coffee (2.5 g), equivalent to a typical high-carb symptom inducing meal: 9.1% protein, 27.5% fat, and 63.4% carbohydrates. Your blood will be drawn at s everal intervals after the test, which is considered the “standard” in testing for reactive hypoglycemia. Why is this the best test? In a recent email to me, researcher Dr. Jean-Frederic Brun told me that reactive hypoglycemia is caused by high insulin sensitivity (and a lower risk of diabetes) whereas the type of hypoglycemia usually seen in prediabetics is caused by low insulin sensitivity. This test will be able to tell the difference.

Ambulatory Glucose Sampling

An at home test. You can do this yourself, if you are comfortable and familiar with blood glucose monitors, or your physician may ask you to perform the test under his guidance. When symptoms occur (sweating, shakiness, palpitations etc.), you sample your blood glucose and note the level. You should also consume sugar/carbs, and note if it alleviates the symptoms. A drawback with this method is that by the time you experience symptoms, your body may already be compensating for too much insulin, and raising your blood glucose levels–by the time you prick your finger, your blood glucose level may already be above the threshold for a reactive hypoglycemia diagnosis.

The Glucose Tolerance Test

The most widely used test, but due to the fact that ten percent of people who take this test will have false positive results, it is not valid as a stand alone test for reactive hypoglycemia (see page 366 of this Clinical Biochemistry book for more on this). You will be asked to drink a glucose drink, then your blood will be tested regularly (every 1/2 hour or hour for as long as 3-5 hours after consuming the drink). Although this is the most widely used test, the high number of false positives also makes it one of the most unreliable tests and should not be used as a sole tool for diagnostic purposes.*
If do do have this test, make sure your doctor orders your insulin levels to be tested as well.

The Breakfast Test

Also not a valid test. Similar to a GTT, with a breakfast test you will be asked to consume a “meal” and your blood will be drawn at intervals. Numerous problems have been cited with this test, including the fact that patients with reactive hypoglycemia rarely have symptoms or a blood glucose drop with this test, which consists of a balanced meal, and not the high-carb meal which typically produces symptoms.

A 42-72 hour fast

Done in a hospital setting, this test is used to diagnose a rare pancreatic tumor called insulinoma. It is so rare a tumor, and so expensive a test, that you will most probably never be asked to have this test done.

The Hypoglycemic Index

A blood test that many researchers have concluded as having no value in the diagnosis of reactive hypoglycemia. If you are ever asked to have this test done to diagnose your reactive hypoglycemia, refer your physician to this article. *see Lev-Ran A, Anderson RW. The diagnosis of postprandial Hypoglycemia. Diabetes, 1981, 30, 996-999

Related posts:

1. Why Test for Reactive Hypoglycemia?
2. Test Results From 5-Hour GTT
3. 5 Hour Glucose Tolerance Test

Featured on :