Questions

I am a 36 yoa male.  In 2003 my doctor sent me to a endocrinologist after having bouts of numbness in my feet and legs after eating, associated with hypoglycemic bouts.  A oral glucose tolerent test showed me to be diabetic.  The bouts continued till he placed me in the hospital for a three day fast with blood sugar levels checked every two hours or so.  After three days, my levels randomly changed from a low of 73 to a high of 132.  The "specialist" stated that my condition was determined to be "reactive hypoglycemia" after he gave me another tolerant test which showed all levels, in normal levels till tests after consuming the sugar.  My C-peptide level rose to 10.5 and my pro-insulin level 55.4 and random insulin level to 40.  My main question concerns the causes.  I questioned him and one reason that he admitted me was to see about the chance of insulinoma's.  He stated that since my fasting level dropped to only 73 he could rule out the insulinoma.  I remain on a low cal diet the best that I can but the problem continues.  I am unable to loose much of any weight.  I fear greatly about the insulinoma but if it is ruled out what could be causing the problems.  Thanks in advance

[Anita Ramsetty, MD]

Hi,
I agree that if your fasting levels dropped only into the 70's an insulinoma is very unlikely, so you should not worry about this too much. You can be retested in future if your symptoms worsen.

For "reactive hypoglycemia", most endocrinologists will place you on a low carbohydrate, high protein diet, not only low calorie. Have you tried this? If not, perhaps you could meet with a dietician/nutritionist to develop a weight loss plan that encompasses lower carbohydrate portions to help with the reactive hypoglycemia component as well.

Best of luck, take care.