Symptoms of Hypoglycemia Without Diabetes Could Be Reactive Hypoglycemia

Reactive hypoglycemia can make you feel weak, anxious, and shaky. Diet changes are the key to controlling this condition.

Reactive Hypoglycemia

Feeling sleepy all the time and experiencing other symptoms of blood sugar dysregulation after a high-carb meal is not normal, nor is it healthy.

© Ariwasabi |

Hypoglycemia, which is low blood sugar, is usually a problem for people with diabetes. When it happens to someone without diabetes it is called non-diabetic hypoglycemia. When someone without diabetes has a blood sugar that drops below 70, it is called reactive hypoglycemia. [1]

What Causes Reactive Hypoglycemia?

Diabetics often get low blood sugar when they take insulin or another antidiabetic medication that drops their blood sugar too low. Insulin, which is produced by you pancreas, is secreted when you eat. It helps sugar (glucose) get into your cells where you need it for energy. Too much insulin causes blood sugar to drop too quickly. Once that energy source is used up, there is not enough blood sugar to replace it, and you get symptoms of hypoglycemia. [1-2]

Reactive hypoglycemia is also caused by too much insulin. It occurs a few hours after eating. The cause is not completely known. It may be a developing failure to regulate insulin secretion that is a warning sign for type 2 diabetes. It can also occur after weight loss surgery, if food passes through your stomach too quickly. [1,2]

Other Types of Non-diabetic Hypoglycemia

Mild symptoms of hypoglycemia are common. They can happen if you exercise and you have not eaten enough, or if you go a long time without eating. You can feel hungry, jittery, weak, or even nauseous. That’s your body telling you that you need sugar for energy. Eating a carbohydrate food that breaks down into sugar will make these symptoms go away. [3]

Postprandial syndrome is symptoms of hypoglycemia that occur about four hours after eating a high carbohydrate meal. This condition does not cause your blood sugar to drop down to below 70. It stays in the low normal range. You may have mild hypoglycemia symptoms. Eating some carbs makes them go away. [1]

Symptoms of Reactive Hypoglycemia

In other causes of non-diabetic hypoglycemia, blood sugar usually does not drop below 70. If you have reactive hypoglycemia, as your blood sugar drops lower, symptoms can start out as mild but they can increase to moderate and serious if you don’t get some sugar into you system. Mild hypoglycemia causes:

  • Hunger
  • Nausea
  • Shakiness
  • Nervousness
  • Palpitations
  • Cold and clammy sweating [3]

Moderate hypoglycemia causes:

  • Mood swings
  • Unsteady weakness
  • Irritability
  • Confusion
  • Blurred vision [3]

Severe hypoglycemia can be life threatening. It can cause you to pass out and have seizures. [3]

Diet Changes for Non-Diabetic Hypoglycemia

sugar content in fruit

Fruit is less likely to wreak havoc on your blood sugar than, say, a bag of gummy worms.

Fortunately, all the causes of nondiabetic hypoglycemia respond to eating some carbs. This will raise you blood sugar and relieve symptoms. You need about 15 grams of carbohydrates, which will break down to sugar for energy. Examples include fruit juice, milk, raisins, hard candy, or a glucose tablet. [3]

For long-term management, it will be important to eat smaller and more frequent meals. Spread your consumption of carbohydrates from foods like fruits, vegetables, and starches out evenly during the day. You should limit high-sugar foods. When you eat a meal, always include a lean protein, some healthy fat, and whole grain foods. These foods slow down your digestion and help you avoid spikes in sugar and insulin. [2]

The key to long-term management is keeping your blood sugar between 70 and 100. To do that you should avoid foods that are high in sugar and cause a rapid increase in insulin. These include:

  • Baked good like cakes, cookies, pies
  • Puddings, custards, ice cream, sherbet, and frozen yogurt
  • Jellies and jams
  • Syrups, honey, and nectars
  • Sweetened drinks and fruit juice over 4 ounces
  • Candy
  • White or brown sugar [1]

Mild symptoms of hypoglycemia that occur occasionally are normal, but if you have symptoms that occur frequently or you have more severe symptoms, let your doctor know. Your doctor may diagnose reactive hypoglycemia from your symptoms and blood testing. [1,3]



  1. UWHealth: Nutrition Management of Low Blood Sugar Without Diabetes (Postprandial Syndrome and Reactive Hypoglycemia).
  2. The Endocrine Society: Non Diabetic Hypoglycemia.
  3. University of Michigan Medicine: Hypoglycemia (Low Blood Sugar) in People Without Diabetes.

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Chris Iliades, MD

Dr. Chris Iliades is board-certified in Ear, Nose and Throat and Head and Neck Surgery from the American Board of Otolaryngology and Head and Neck Surgery. He holds a medical … Read More

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