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Ambulatory blood glucose measurement, dietary composition and physical activity levels in otherwise healthy women reporting symptoms that they attribute to hypoglycaemia

Published online by Cambridge University Press:  08 March 2007

Elizabeth J. Simpson ,
Michelle Holdsworth  and
Ian A. Macdonald
Elizabeth J. Simpson*
Affiliation:
University of NottinghamSchool of Biomedical SciencesQueen's Medical CentreNottinghamNG7 2UHUK
Michelle Holdsworth
Affiliation:
University of NottinghamSchool of Biomedical SciencesQueen's Medical CentreNottinghamNG7 2UHUK
Ian A. Macdonald
Affiliation:
University of NottinghamSchool of Biomedical SciencesQueen's Medical CentreNottinghamNG7 2UHUK
*
*Corresponding author: Miss E. J. Simpson, fax +44 (0) 115 9709259, email liz.simpson@nottingham.ac.uk
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Abstract

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Reactive hypoglycaemia (RH) is a condition that has been popularised in the media and lay literature, particularly that targeting women, over the past 30 years. The objective of the present study was to investigate whether a non-patient group reporting symptoms that they attributed to a low blood glucose level would demonstrate biochemical hypoglycaemia when symptomatic and whether their habitual diet and activity level differed from those of controls. Thirty non-obese, healthy women (aged 19–45 years) reporting symptoms more than once a week that they attributed to hypoglycaemia (RH group), and eighteen controls, measured their finger-prick blood glucose level 3h after breakfast and lunch, and recorded their diet and activity daily for 7d. The RH group also measured their blood glucose when symptoms were being experienced. Symptoms less than 4h after eating were classed as postprandial. The mean postprandial blood glucose level in the RH group when asymptomatic (4·66 (sem 0·08) mmol/l) was significantly lower than that of controls (5·05 (sem 0·11) mmol/l; P<0·01). Symptoms occurred 2·6 (sem 0·13) h after eating, at a lower blood glucose level (4·18 (sem 0·10) mmol/l; P<0·001) than when the women were asymptomatic. On symptomatic days, the RH group were more physically active than the controls (1·64 (sem 0·04) v. 1·50 (sem 0·03) multiples of resting energyexpenditure; P<0·05), with a lower energy intake (7901 (sem 311) et al.. 9332 (sem 227) kJ; P<0·001). In conclusion, subjects reporting symptoms they associated with hypoglycaemia generally did not demonstrate biochemical hypoglycaemia but did have significantly lower blood glucose levels than controls. Higher physical activity and a failure to match energy intake to estimated energy requirement may be important in the aetiology of symptoms.

Keywords

Reactive hypoglycaemiaWomenDiet
Type
Research Article
Information
British Journal of Nutrition , Volume 95 , Issue 6 , June 2006 , pp. 1127 - 1133
Copyright
Copyright © The Nutrition Society 2006

References

Ainslie, PNCampbell, ITFrayn, KNHumphreys, SMMacLaren, DP & Reilly, TPhysiological, metabolic, and performance implications of a prolonged hill walk: influence of energy intake. J Appl Physiol 2003 94, 1075–1083.CrossRefGoogle ScholarPubMed
Ainsworth, BEHaskell, WLWhitt, MCet al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000 32, S498–S504.CrossRefGoogle ScholarPubMed
Anthony, DDippe, SHofeldt, FDDavis, JW & Forsham, PHPersonality disorder and reactive hypoglycemia. A quantitative study. Diabetes 1973 22, 664–675.CrossRefGoogle ScholarPubMed
Atkins, RCDr Atkins New Diet Revolution, Vermillion ed. London: Random House (2003)Google Scholar
Berlin, IGrimaldi, ALandault, CCesselin, F & Puech, AJSuspected postprandial hypoglycemia is associated with beta-adrenergic hypersensitivity and emotional distress. J Clin Endocrinol Metab 1994 79, 1428–1433.Google Scholar
Betteridge, DJReactive hypoglycaemia. Br Med J (Clin Res Ed) 1987 295, 286–287.CrossRefGoogle ScholarPubMed
Black, AEGoldberg, GRJebb, SALivingstone, MBCole, TJ & Prentice, AMCritical evaluation of energy intake data using fundamental principles of energy physiology. 2. Evaluating the results of published surveys. Eur J Clin Nutr 1991 45, 583–599.Google ScholarPubMed
Brun, JFBouix, OMonnier, JFBlachon, CJourdan, NBaccara, MTFedou, C & Orsetti, AIncreased insulin sensitivity and basal insulin effectiveness in postprandial reactive hypoglycaemia. Acta Diabetolog 1995 33, 1–6.CrossRefGoogle Scholar
Brun, JFDumortier, MFedou, C & Mercier, JExercise hypoglycaemia in nondiabetic subjects. Diabetes Metab (Paris) 2001 27, 92–106.Google Scholar
Brun, JFFedou, C & Mercier, JPostprandial reactive hypoglycemia. Diabetes Metab 2000 26 337–351.Google ScholarPubMed
Daly, MSugars, insulin sensitivity, and the postprandial state. Am J Clin Nutr 2003 78, 865S–872S.CrossRefGoogle ScholarPubMed
Daly, MEVale, CWalker, MLittlefield, AAlberti, KG & Mathers, JCAcute effects on insulin sensitivity and diurnal metabolic profiles of a high-sucrose compared with a high-starch diet. Am J Clin Nutr 1998 67, 1186–1196.CrossRefGoogle ScholarPubMed
DeFronzo, RATobin, JD & Andres, RGlucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 1979 237, E214–E223.Google ScholarPubMed
Hansen, PANolte, LAChen, MM & Holloszy, JOIncreased GLUT-4 translocation mediates enhanced insulin sensitivity of muscle glucose transport after exercise. J Appl Physiol 1998 85, 1218–1222.CrossRefGoogle ScholarPubMed
Heller, RF & Heller, RFThe Carbohydrate Addict's Lifespan Program: Personalized Plan for Becoming Slim, Fit & Healthy in Your 40's 50's 60's and Beyond. New York: Signet. 2001.Google Scholar
Himsworth, HPThe dietetic factor determining the glucose tolerance and sensitivity to insulin of healthy men. Clin Sci (Lond) 1935 2, 67–94.Google Scholar
Johansson, LSolvoll, KBjorneboe, G-EA & Drevon, CAUnder- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. Am J Clin Nutr 1998 68, 266–274.CrossRefGoogle ScholarPubMed
Mayer-Davis, EJD'Agostino, RKarter, AJ Jr Haffner, SMRewers, MJSaad, M & Bergman, RNIntensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. JAMA 1998 279, 669–674.CrossRefGoogle ScholarPubMed
Mitrakou, ARyan, CVeneman, TMokan, MJenssen, TKiss, IDurrant, JCryer, P & Gerich, JHierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction. Am J Physiol 1991 260, E67–E74.Google ScholarPubMed
Nemet, DConnolly, PHPontello-Pescatello, AMRose-Gottron, CLarson, JKGalassetti, P & Cooper, DMNegative energy balance plays a major role in the IGF-I response to exercise training. J Appl Physiol 2004 96, 276–282.CrossRefGoogle Scholar
Palardy, JHavrankova, JLepage, RMatte, RBelanger, RD'Amour, P & Ste-Marie, L-GBlood glucose measurements during symptomatic episodes in patients with suspected postprandial hypoglycaemia. N Engl J Med 1989 321, 1421–1425.CrossRefGoogle Scholar
Pelchat, MLJohnson, AChan, RValdez, J & Ragland, JDImages of desire: food-craving activation during fMRI. Neuroimage 2004 23, 1486–1493.Google Scholar
Schofield, WNPredicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 1985 39 Suppl. 15–41.Google Scholar
Service, FJHypoglycaemia and the postprandial syndrome. N Engl J Med 1989 321, 1472–1474.CrossRefGoogle ScholarPubMed
Simpson, EJHoldsworth, M & Macdonald, IAPrevalence of self-reported symptoms attributed to hypoglycaemia within a female population of the UK. J Psychosom Res 2006 60, 403–406.CrossRefGoogle ScholarPubMed
Snorgaard, O & Binder, CMonitoring of blood glucose concentration in subjects with hypoglycaemic symptoms during everyday life. BMJ 1990 300, 16–18.CrossRefGoogle ScholarPubMed
Tamburrano, GLeonetti, FSbraccia, PGiaccari, ALocuratolo, N & Lala, AIncreased insulin sensitivity in patients with idiopathic reactive hypoglycaemia. J Clin Endocrinol Metab 1989 69, 885–890.Google Scholar
Ware, JEGandek, B JrKosinski, MThe equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998 51, 1167–1170.Google Scholar
Yager, J & Young, RTNon-hypoglycaemia is an epidemic condition. N Engl J Med 1974 291, 907–908.CrossRefGoogle Scholar