September 17, 1973

Variants of Alimentary Hypoglycemia

JAMA. 1973;225(12):1528-1529. doi:10.1001/jama.1973.03220400054016

Oversold to the public by "authorities" of questionable repute, hypoglycemia has been added to the popular list of "dread" diseases. After the statement by the American Diabetes Association, the Endocrine Society, and the American Medical Association (223:682, 1973) about the grossly exaggerated unwarranted reports on the prevalence and dangers of hypoglycemia, one almost feels compelled when commenting on this condition to reassure the reader that no call for alarm is intended. The variants of hypoglycemia under consideration are much too rare to cause concern.

As distinct from hypoglycemia caused by insulin-secreting tumors, reactive hypoglycemia occurs not when fasting, but in response to food intake. In the absence of a hepatic, pituitary, or adrenal disorder, a postprandial fall in blood glucose level in the adult may represent a poorly understood emotion-linked "functional" hypoglycemia. In another context, it may be an early manifestation of maturity-onset diabetes when delayed insulin response to glucose