What causes hypoglycemia in people without diabetes?
There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. Reactive hypoglycemia Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal. Researchers don’t yet know the exact cause. But they think it happens due to a sudden spike and then fall in blood sugar after eating certain foods, especially simple carbohydrate foods like white rice, potatoes, white bread, cake and pastries. Bariatric surgery can also result in reactive hypoglycemia. After certain types of bariatric surgery, such as gastric bypass surgery, your body absorbs sugars very quickly, which stimulates excess insulin production. This can then cause hypoglycemia. Your body usually corrects reactive hypoglycemia on its own, but consuming carbohydrates may help your symptoms go away more quickly. Fasting hypoglycemia For the majority of people without diabetes, not eating food for a long time (fasting) doesn’t lead to hypoglycemia. This is because your body uses hormones and stored glucose to manage your blood sugar. However, certain conditions and situations can lead to fasting hypoglycemia in people without diabetes, including: Excessive alcohol consumption: Alcohol prevents your body from forming new glucose cells (gluconeogenesis). If you drink excessive amounts of alcohol over several days and don’t eat much, your body can run out of stored glucose (glycogen). This can lead to hypoglycemia because your body can’t properly regulate your blood sugar. Critical illness: You can experience hypoglycemia in critical illness states, such as end-stage liver disease, sepsis, starvation or kidney failure. This is because your body is using stored glucose for energy faster than your body can create new glucose cells from the food you eat. Adrenal insufficiency: Adrenal insufficiency causes lower-than-normal cortisol levels. As cortisol (a hormone) helps regulate your blood sugar by increasing it, having low levels of cortisol can lead to hypoglycemia episodes. Non-islet cell tumor hypoglycemia (NICTH): This is a rare but serious syndrome in which a tumor releases excess insulin-like growth factor 2 (IGF-2). This is a hormone that has similar effects as insulin. Excess IGF-2 causes hypoglycemia. A wide variety of benign (noncancerous) and malignant (cancerous) tumors can cause NICTH. Insulinoma: An insulinoma is a rare tumor in your pancreas that produces excess insulin. It leads to hypoglycemia episodes — most commonly in the early morning. In rare cases, non-diabetes-related medications can lead to hypoglycemia, such as beta-blockers and certain antibiotics. If you’re experiencing hypoglycemia and don’t have diabetes, talk to your healthcare provider.