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Hypoglycemia Without Diabetes

Hypoglycemia without diabetes can occur when your blood sugar levels fall too low. It is more common in people with diabetes, but it can also affect people who don’t have the disease. Learn more about nondiabetic hypoglycemia, including prevention and treatment.

Last Modified: November 4, 2022
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What Is Hypoglycemia?

Hypoglycemia happens when a person’s blood sugar, also called blood glucose, falls below the normal range the body needs to function. Most people who experience hypoglycemia have diabetes and take insulin to lower blood sugar.

For those with diabetes, hypoglycemia may be the result of taking too much insulin or not balancing medication with regular meals. It is more common in people with type 1 diabetes. About 10% of people with type 1 diabetes account for 70% of hypoglycemia episodes.

Some people who don’t have diabetes can experience nondiabetic hypoglycemia symptoms. People with nondiabetic hypoglycemia usually have a different health problem that affects their body’s ability to store or metabolize glucose.

Symptoms of nondiabetic hypoglycemia include:
  • Increased hunger
  • Nausea
  • Sweating
  • Tremors
  • Dizziness and lightheadedness
  • Fatigue and lethargy
  • Heart palpitations
  • Behavioral changes
  • Confusion
  • Difficulty concentrating or speaking
  • Blurry or spotty vision

Hypoglycemia symptoms should be taken seriously. If you have not been diagnosed with diabetes and experience any of these symptoms, contact your doctor immediately.

What Causes Low Blood Sugar Without Diabetes?

Hypoglycemia can have several different causes. A number of factors can throw off the balance of insulin and glucose, leading to low blood sugar.

While low blood sugar is not an uncommon issue for people with diabetes, you don’t have to have diabetes to experience low blood sugar.

Some factors that can cause hypoglycemia include:
  • High Alcohol Consumption: Alcohol inhibits your liver’s ability to manage glucose, especially if you haven’t eaten.
  • Medications: Certain medications speed up the rate at which your body uses glucose. They can also make it harder for your body to store glucose. These include beta blockers, drugs that fight strong infections, and metformin when taken with sulfonylureas.
  • Liver Disease: Liver problems deplete glycogen stores and make it difficult for the body to replenish them.
  • Kidney Disease: Kidney problems can cause malnutrition and reduced insulin clearance, leaving you with less glucose and more insulin than your body needs.
  • Glycogen Storage Diseases: These diseases affect the liver’s ability to regulate your body’s use of glucose.
  • Pancreatic Tumors: Because your pancreas creates insulin, these growths can affect insulin production and secretion.
  • Severe Infections: Infections can cause your body to use more glucose than normal, which can affect blood sugar levels.
  • Insulin Receptor Antibodies: If your body produces abnormal levels of insulin, specifically too much insulin, or if you have too many insulin receptor antibodies, it can be more difficult for you to regulate blood sugar.
  • Gastric Surgeries: Scientists are not sure why people who have had gastric surgery, including gastric bypass surgery, are more likely to experience hypoglycemia. Changes in digestion could play a role.

Symptoms of nondiabetic hypoglycemia in someone who does not have diabetes could be an indication of a serious underlying condition. Hypoglycemic episodes are dangerous regardless of their cause, so be sure to seek medical attention.

Reactive Hypoglycemia

Reactive hypoglycemia, also called postprandial hypoglycemia, is low blood sugar that occurs a few hours after eating a meal. This happens because of a spike in your body’s insulin levels.

Reactive hypoglycemia is most likely to occur after eating a meal that is high in carbohydrates, but it can happen after consuming any food. People who experience reactive hypoglycemia may be at a higher risk of developing diabetes.

Fasting Hypoglycemia

Fasting hypoglycemia occurs when a person goes too long without eating. It can take anywhere from a few hours to a few days to occur. Most people eat long before their blood sugar becomes critically low, making fasting hypoglycemia relatively rare.

Underlying health problems or heavy alcohol consumption can also deplete your glucose stores.

Dumping Syndrome and Hypoglycemia

Dumping syndrome, also known as rapid gastric emptying, occurs when your body moves food from your stomach to your small intestine more quickly than normal. Your body then has less time to absorb the glucose in any high-carbohydrate food you eat.

Your small intestine holds an abnormally large amount of glucose as a result, which stimulates insulin production in your pancreas. This spike in insulin production can cause your blood sugar to drop suddenly, resulting in hypoglycemia.

Dumping syndrome is more common in people who have had gastric surgery. However, anyone can develop this condition.



Who Is at Risk for Hypoglycemia Without Diabetes?

Hypoglycemia without diabetes may be rare, but research shows it is more common in certain segments of the population. People at higher risk of experiencing nondiabetic hypoglycemia include:

  • People with underlying health conditions, especially kidney, liver or heart conditions
  • Those with a family history of diabetes
  • People who have had stomach or esophageal surgery

If you experience symptoms of hypoglycemia and have not been diagnosed with diabetes, talk to your doctor. They likely will order diabetes tests to rule out the condition before investigating your symptoms further.

Nondiabetic Hypoglycemia Prevention & Treatment

The first step in treating nondiabetic hypoglycemia is to figure out the cause. Once your doctors determine the underlying problem they can prescribe the appropriate course of treatment.

A diet for diabetes may be part of your doctor’s recommendations. A dietitian can help you create the best diet for your needs. Despite the name, these diets are not just for people with diabetes. They contain a healthy balance of macronutrients that help stabilize blood sugar even in people who do not have diabetes.

It may take time for your condition to improve. Your doctor can provide additional health information to help you keep your blood sugar levels in balance and prevent hypoglycemia.



Please seek the advice of a medical professional before making health care decisions.
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