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Last Updated on June 22, 2022


Have you ever experienced a bout of wooziness or nausea after a meal? It is possible you might have experienced an episode of Reactive Hypoglycemia.

This condition refers to low blood sugar/glucose levels that fall under the range of 70 mg/dL. It most commonly occurs within four hours of a meal. Episodes of reactive hypoglycemia can occur in both people with or without diabetes. This is primarily caused by the body releasing more insulin than is needed for the food consumed. Many physicians highly recommend monitoring your blood glucose levels throughout the day so that you are better able to keep track of your health and what you consume.

What Causes Reactive Hypoglycemia?

Such a “mismatch” between insulin needed & insulin released can occur in patients with insulin resistance (a condition in which the body makes insulin but the insulin does not work properly). The body initially compensates by making more insulin so that blood glucose levels remain normal for a while. However, ultimately over time, the insulin production decreases as your pancreas “get tired” and therefore blood glucose levels begin to rise. This can be one of the reasons why diabetes develops.

During the ”early prediabetes phase”, if these individuals eat high carb meals or consume sugary drinks, sometimes their pancreas may release too much insulin and this may lead to “reactive hypoglycemia”. Thus, reactive hypoglycemia can identify those individuals, who are at risk of developing type 2 diabetes down the road.

Reactive hypoglycemia can also occur in some individuals after they undergo certain bariatric procedures (e.g. gastric bypass surgery). More rarely, tumors making insulin (insulinomas) can cause the occurrence of this condition, although such patients more often develop hypoglycemia in the overnight period when they have not eaten for several hours. It is just as important for diabetics to constantly keep track of blood glucose levels due to their fluctuating blood sugar levels.

If you are someone affect by reactive hypoglycemia, some dietary and lifestyle changes can help you manage and avoid hypoglycemic episodes.

Hypoglycemia vs. Reactive Hypoglycemia

Reactive hypoglycemia is also known as postprandial hypoglycemia. It occurs 2-4 hours after consuming a meal. This lowering of blood sugar levels is different from the normal hypoglycemia that usually occurs due to fasting. For people facing the symptoms of reactive hypoglycemia, its cause is commonly unknown.

In the case of reactive hypoglycemia, the symptoms usually occur due to the type of food that was consume or the movement of the food through the digestive tract (specifically the intestines).

Some other most common causes of reactive hypoglycemia include the consumption of alcohol, inherited metabolic disorders or tumors, or certain surgeries such as bariatric surgery.

Usually, medical testing is done to evaluate the causes of hypoglycemia. Additional testing is done to evaluate whether the lowering of blood glucose levels is caused by some underlying condition and/or, simply due to hypoglycemia and in order for blood glucose levels to return to normal.

Reactive Hypoglycemia usually does not require any kind of medical attention. However, if it occurs due to some underlying medical condition, those are then treat by doctors. If you are on diabetes medication (that lowers the blood sugar levels) and undergo bouts of hypoglycemia after a meal. You might need to consider talking to your doctor about adjusting your dose.

Signs & Symptoms of Reactive Hypoglycemia

It is important to note that many of the signs and symptoms observed in reactive hypoglycemia may also be applicable to those who have hypoglycemia due to diabetes. Some of these symptoms include:

  • Sweating or chills,
  • Nausea,
  • Shaking and trembling,
  • Headaches,
  • Bout of hunger,
  • Weakness and dizziness, and
  • Faster heart rates.

How To Avoid Reactive Hypoglycemia?


Tips For Reactive HypoglycemiaDietary modifications can frequently help lessen your symptoms and make you feel better. Change the timing and composition of your meals by doing things like:

  • Eating large amounts of simple processed carbohydrates such as pasta or white bread, particularly on an empty stomach.
  • Consuming excess products with added sugar such as soda, fruit juice, candy, and baked goods.
  • Going long periods of time (over four or five hours) without eating; try to have a snack with about 15-30 grams of carbohydrate with a protein source if you won’t be eating a meal for a long while.
  • A high amount of alcohol consumption, and especially using soft drinks or fruit juices as mixers.
  • Eating unbalanced meals heavy in carbohydrates.

Tips To Get Your Reactive Hypoglycemia Under Control

Some of the simple tips anyone can follow to get their reactive hypoglycemia includes being diet conscious and taking care of what you put in your body. Experts suggest that shifting your diet to include food that falls under the “low glycemic index” can be extremely beneficial for both diabetics and non-diabetics.

Choose complex carbohydrates high in fiber, vitamins, and minerals; like whole-wheat bread over white bread, sweet potatoes over white potatoes, and whole wheat pasta over regular. Legumes, beans, and lentils are also good complex carbohydrate choices that are also high in protein.

  • Eat small meals every 3 or 4 hours, rather than restricting yourself to large meals, only three times a day.
  • Balance each meal by filling your plate with lots of soluble fiber from leafy greens and vegetables; include lean protein sources like chicken, turkey, fish, and non meat proteins; and have a small source of starch carbohydrate, such as a fist-sized ball of rice.
  • If you drink alcohol, drink in moderation (one drink per day for women, two for men) and have your drink with a meal.

The Bottom-line

Listen to your body. If you feel any of the signs and symptoms above, consider talking to a physician near you or a dietitian for a diet plan that may better help you cope with your symptoms. Usually, symptoms of reactive hypoglycemia do not warrant any serious medical attention. However, if there are any unknown underlying medical conditions, an experienced doctor may be able to catch them early on and help treat them.

(This blog is for informational purposes and should not be used as medical advice.) 

Dr. Wasim Haque M.D., F.A.C.E.

Dr. Wasim A. Haque graduated from the Aga Khan University Medical College with a medical degree. In Flower Mound, Texas, he works as an Endocrinology, Internal Medicine, Diabetes, and Metabolism Specialist. He has been in practice for more than 30 years.