How is hypoglycemia diagnosed?
In addition to a complete medical history and clinical examination, the diagnostic procedures for hypoglycemia may include blood tests.
Fasting blood tests
Patients are observed for symptoms during a morning visit to the physician's office, having fasted since 6 pm the previous evening.
Blood glucose, insulin, other hormones and some medication levels are checked in the office.
The 72-hour fast
The 72-hour fast with testing for blood glucose and insulin is the most reliable diagnostic test. The patient is observed in a hospital setting under a standardized protocol for signs and symptoms of hypoglycemia. Blood is drawn initially every 6 hours for multiple tests and then at 1 to 2 hour intervals when glucose levels fall to 60 mg/dL. The fast is concluded when glucose falls to 40 mg/dL and the patient demonstrates signs or symptoms of hypoglycemia. Hypoglycemia alone is not enough for diagnosis.
Five hours oral glucose tolerance test
Postprandial (reactive) hypoglycemia has traditionally been evaluated using the 5-hour oral glucose tolerance test.(Glucose is given by mouth and blood is drawn every hour for five hours). However, a mixed meal test (in which patients eat a meal similar to that which leads to symptoms during ordinary life activities) is preferred for screening. Home testing is not considered very reliable, especially in the hypoglycemic range.
Treatment for hypoglycemia
Specific treatment for hypoglycemia will be determined by your physician based on the specific cause and extent of the disease, your age and overall health.
- Eating sugar when having symptoms of hypoglycemia may relieve them. Also eating frequent, small meals is sometimes recommended in reactive hypoglycemia.
- If the hypoglycemia is a result of an insulin-producing tumor in the pancreas, the tumor is usually removed surgically.
- Treatment may also include taking glucagon, a protein hormone secreted by the pancreas to stimulate the liver to produce glucose.