EVALUATION OF A STANDARDIZED HYPERGLUCIDIC - BREAKFAST TEST IN POSTPRANDIAL REACTIVE HYPOGLYCEMIA

The oral glucose tolerance test is not specific for diagnosing postpra ndial reactive hypoglycaemia, since it too frequently induces low bloo d glucose values in subjects who have never complained of symptoms of this. By contrast, the mixed meal tests are deceptive for this purpose because they do not induce hypoglycaemia in subjects who have complai ned of of hypoglycaemic symptoms. We investigated the frequency of hyp oglycaemia after a standardized hyperglucidic breakfast test in three groups of subjects:group A, 43 control subjects; group B, 38 postprand ial reactive hypoglycaemic patients; group C, 1193 asymptomatic subjec ts undergoing assessment of glycoregulation. In the 38 subjects with s uspected reactive hypoglycaemia the mean blood glucose nadir was 3.48 +/- 0.08 mmol/l, i.e. lower than in control subjects (4.83 +/- 0.13 p < 0.0001). Blood glucose levels less than 3.3 mmol/l were found in 47. 3 % of subjects with suspected postprandial reactive hypoglycaemia (gr oup B), i.e more frequently than in control subjects (group A: 2.2 % p = 1.6 x 10(-6)) and asymptomatic subjects (group C: 1 % p = 8 x 10(-2 2)). This markedly higher frequency of low blood glucose values in sub jects with postprandial symptoms compared with control and asymptomati c subjects suggests that this test detects a tendency to hypoglycaemia after a standardized hyperglucidic breakfast. Since this test mimics average French eating habits, the results suggest that the patients un dergo such symptoms in their everyday life, and that the hyperglucidic breakfast test is a simple alternative to ambulatory glucose sampling for diagnosis of postprandial reactive hypoglycaemia.