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Conditions and Diseases > Diabetes Forum > Reative postprandial hypoglycemia
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Q: Reative postprandial hypoglycemia
asked by: DoctorQuestion on November 12th, 2008
Where do I begin? Could my experience at work have been related to a low blood sugar even though my level was 98 after I drank a soda? Was it a type of siezure? Where do I go from here? I don't even have a family physician. Only a neurologist/psyciatrist in whom I am disappointed to say but is letting me suffer and has no answers or direction for me. He is now out of the office until Jan. I would have to travel a hour to see his replacement and don't have transportation there. What do make of all of this? Thanks for your help.


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Dr. Goce Aleksovski , MD
replied on November 15th, 2008
Diabetes Answer A4889
According to the symptoms you report, it seems that you might have experienced reactive postprandial hypoglycemia (blood sugar lowering due to high levels of insulin in the blood as a reaction to ingesting a hyperconcentrated carbohydrates drink). Hypoglycemia (lower blood sugar levels) is characterized with nervousness, sweating, intense hunger, trembling, weakness, palpitations and often having trouble thinking and speaking. They act as warning signs to urge you to eat. At this level, the brain can still access circulating blood glucose for fuel. The symptoms provide a person the opportunity to raise blood glucose levels before the brain is affected.

If a person does not or cannot respond by eating something to raise blood glucose, the levels of glucose continue to drop. Somewhere in the 50 mg/dl range, most patients progress to neuro-glyco-penic ranges (the brain is not getting enough glucose). At this point, symptoms progress to confusion, unawareness, drowsiness, behavioral changes, comma and so-called non-epileptic seizure (non-epi seizure).

All in all, you might have gone to a wrong specialist for this matter. It seems that a more appropriate one might have been an endocrinologist-diabetologist who would have treated the cause-glucose intolerance.

As for the antidepressants, if SSRI (selective serotonin reuptake inhibitors) do not help, maybe your neurologist/psychiatrist might want to change your medication to putting you on serotonin-norepinephrine reuptake inhibitor (SNRI), but this is strictly a specialist’s decision.

However, it might be wise to choose a family physician, to coordinate the work of all needed specialists and who should know your whole health status best.




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