TITLE:
Idiopathic Reactive Hypoglycemia: Mechanisms of Onset and Remission with High Protein Low Carbohydrate Diet
AUTHORS:
Keshavan Prakash, Mary Kabadi, Udaya M. Kabadi
KEYWORDS:
Idiopathic Reactive Hypoglycemia, High Protein, Low Carbohydrate Diet
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.5 No.9,
September
23,
2015
ABSTRACT: Objective: Idiopathic
reactive hypoglycemia is defined as early postprandial hypoglycemia occurring
on ingestion of high carbohydrate containing meal. Remission ensues with high
protein low carbohydrate diet. This study assessed roles of insulin and
glucagon in its onset and remission. Methods: Plasma glucose, insulin and
glucagon were determined after an overnight fast and repeatedly until 180 minutes
on ingestion of 3 meals; 100 g glucose; 100 g pure protein liquid and mixture
of 50 g each at 14 days’ interval. Five adults with IRH and 6 age matched
healthy volunteers participated. Results: In IRH, glucose ingestion induced
prompt rise in glucose (5.1 ± 0.8 to10.5
± 1.2 mM/L) followed later by hypoglycemia (2.6 ± 0.4 mM/L). Insulin rose from
7 ± 2 to 90 ± 18 mU/L. Glucagon
rose initially (10% ± 2%) from elevated basal concentration (373 ± 57 mU/L)
followed by later decline (-43% ± 12%). On protein ingestion, glucose declined
followed by a restoration to basal level while both insulin and glucagon rose
(28 ± 6 mU/L; 148% ± 38%, p