General Measures

• Outpatient except for severe cases; may also be inpatient for testing
• Oral carbohydrate for alert patient without drug overdose (2–3 Tbs of sugar in glass of water or fruit juice, 1–2 cups of milk, piece of fruit, or several soda crackers) (1)[C]
• If unable to swallow: Use glucagon IM or SC (1)[C].
• If caused by medication or nutrients: Avoid or control causative agents (1)[C].
• If triggered by meals: Try high-protein diet with carbohydrate restriction (1)[C].
• Nonhypoglycemic hypoglycemia or pseudohypoglycemia:
  • Many patients (often females, aged 20–45) present with diagnosis of reactive hypoglycemia (self-diagnosed or misinterpretation of tests)
  • Symptoms may pertain to chronic fatigue and somatic complaints (stress often playing a role in these symptoms).
  • Management difficult; listening is important. Try 120-g carbohydrate diet (1)[C].
  • Counseling may be useful for stress and other problems.