Article (Scientific journals)
L’hypoglycémie réactionnelle : un trouble fonctionnel fréquemment évoqué, mais surestimé en pratique clinique.
Scheen, André; Paquot, Nicolas; Lefèbvre, Pierre
2023In Revue Médicale de Liège, 78 (5-6), p. 363-368
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Keywords :
Sugars; Blood Glucose; Humans; Hypoglycemia/diagnosis/etiology/therapy; Diagnosis, Differential; Sugars/therapeutic use; Dizziness; Hypoglycaemia; Postprandial; Whipple triad; diagnosis
Abstract :
[en] Malaises are often attributed to hypoglycaemia in nondiabetic people who don't have any other serious medical problem. Reactive hypoglycaemia, the most frequent one, may be considered as a functional disorder. However, its diagnosis is often overused, because not really demonstrated in most instances. The diagnosis of hypoglycaemia should be structured, based upon the Whipple triad. First, the medical interrogatory must search for adrenergic and neuroglucopenic symptoms that suggest hypoglycaemia. Second, if the malaise is due to a hypoglycaemia, it should resume rapidly after the administration of sugar. Third, hypoglycaemia must be confirmed by a measurement of a low glucose level at the time of a malaise. The latter approach is facilitated by the use of home blood monitoring, a strategy that is now preferred to the use of an oral glucose tolerance test, a non-physiological test far from real-life conditions. When the diagnosis is made based upon this triad, the medical interview should precise the severity of the symptoms and focus on the chronology of the malaises, typically 2-3 hours after a sugar-enriched meal in case of a reactive hypoglycaemia. Therapeutic approach of this functional disorder mostly relies on dietary advices.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Scheen, André  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques
Paquot, Nicolas ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques
Lefèbvre, Pierre ;  Université de Liège - ULiège > > Diabétologie (succ. P. Lefebvre)
Language :
French
Title :
L’hypoglycémie réactionnelle : un trouble fonctionnel fréquemment évoqué, mais surestimé en pratique clinique.
Alternative titles :
[en] Reactive hypoglycaemia, a frequently mentioned functional disorder, yet overestimated in clinical practice.
Publication date :
May 2023
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Be
Special issue title :
Troubles fonctionnels
Volume :
78
Issue :
5-6
Pages :
363-368
Peer reviewed :
Editorial Reviewed verified by ORBi
Available on ORBi :
since 17 July 2023

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