Ask the Expert – Managing Reactive Hypoglycemia

Ask The Expert is a weekly column on The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

I did not know about reactive hypoglycemia until recently when a Mom asked me this question on our Facebook page. This week, Registered Dietitian Karman Meyer explains what it is and what you can do to manage the blood sugar levels to avoid potentially life threatening symptoms.

Karman Meyer, RD LDN
  • Education: Dietetic Internship completed at Vanderbilt Medical Center, B.S. in Dietetics from Miami University
  • Certifications: Registered Dietitian, Licensed Dietitian/Nutritionist in Tennessee
  • Experience: Clinical Dietitian, Diabetes Educator, Nutrition Writer
  • Twitter: @food_delights
  • Website: Nutrition Adventures
  • LinkedIn Profile
  • Contact via email:

Question: I have a profoundly gifted, almost 3 year old, son with reactive hypoglycemia. Would love to know more about keeping his blood sugar level.


Reactive hypoglycemia, also known as postprandial or alimentary hypoglycemia, is a rare condition that causes an individuals’ blood sugar, or blood glucose, to drop below 70 mg/dL typically within 4 hours after eating a meal. A significant drop in the blood sugar level after eating is caused by an excess production of insulin for digestion of carbohydrate-rich foods. Symptoms of reactive hypoglycemia are similar to diabetes-related hypoglycemia, which include light-headedness, sweating, confusing, hunger, and weakness. The cause of reactive hypoglycemia is still uncertain, but individuals who have had gastric surgery may develop this disorder.

Because a low blood sugar level can be potentially dangerous if not treated right away, it is best to prevent it from occurring. To help avoid hypoglycemia, individuals with reactive hypoglycemia should try the following:

  • Eat small meals or snacks every 3 hours
  • Make sure meals and snacks contain foods from a several food groups (protein, dairy, fruits, vegetables, and grains)
  • Limit foods that are high in simple sugars (soda, candy, cakes, pastries), especially if eating on an empty stomach
  • Choose foods high in soluble fiber (oatmeal, citrus fruits, carrots, and beans)

Be prepared and pack a carbohydrate-containing snack when the next meal is several hours away to prevent drops in blood sugar.  If hypoglycemia does set in, be sure to take action and treat the low blood sugar immediately. Glucose tablets are effective for quickly raising blood sugar levels and should be carried at all times in case food is unavailable.

Living with reactive hypoglycemia can be very manageable. The most important point to remember is that people with reactive hypoglycemia need to eat a variety of foods at meals and snacks, and should eat at least every 3 hours. By planning balanced and appropriate meals and snacks ahead of time, low blood sugars can be prevented.

©2010 All Rights Reserved

Disclaimer – Information provided in Ask The Expert column on is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by

1 comment

  1. Loco112

    Your generalized advise could potentially harm that child.  You need to have the parent make sure that he child does not suffer from a type of Reactive hypoglycemia that is not controlled by diet modification.  You are giving very general advice on a very specific topic, a nd it could kill the child.   If the child has eaten low glycemic foods before, such as: meat or hard cheese, he/she still experienced hypo symptoms, even if only at random times, then he/she could have a “non diet controlled reactive hypoglycemia”.   If the child has that type of hypo and follows your suggestiung of consuming just one high glycemic index meal on a bad day, that might just put him/her into a low BG induced coma and could cause irreversible brain damage and even cause hi/her death.

    If any of you have seen symptoms like the typical hypo symptoms in your child, or they are extremely tired after a small low glycemic (low carb) lunch, talk to an endocrinologist that specializes in reactive hypoglycemia (they are very rare doctors) have them check their blood sugar while feeding a very low glycemic meal and if you see a low number at any time post meal.

    If a person with “non diet controlled reactive hypoglycemia” is having blood glucose symptoms and issues, do not give them sugar, or other high-carb foods, call 911 and tell the ER that you have “non diet controlled reactive hypoglycemia” and the patient might then have to have glucagon followed by glucose, but at very controlled dosages and timing. 

Comments are closed.