The short answer is yes, it is possible to have hypoglycaemia, or low blood sugar, without being diabetic. I’m not sure how much information you want, though, since you have not stated whether you’ve been properly diagnosed with the condition or not. For purposes of this reply, I will assume that you have been professionally diagnosed and had your blood glucose levels measured, and that you are sure your symptoms are related to non-diabetic hypoglycaemia. However, if you have not been properly diagnosed, I would recommend that you consider consulting your health care provider to rule out more serious pathology, e.g. kidney, liver, pancreas or metabolic disorders, as the cause of your symptoms, since non-diabetic hypoglycaemia can exhibit the same type of symptoms as diabetes-related hypoglycaemia.

The causes of non-diabetic hypoglycaemia can be an excess of insulin in the blood, as well as other disease processes. These include reactive hypoglycaemia (the most common type) and organic hypoglycaemia (often due to a benign pancreatic tumour), insulin overdose, impaired liver function, Addison’s disease (adrenal glands), pituitary gland impairment, gastrectomy (full or partial stomach removal), malnutrition and/or fasting, or alcohol consumption.

The condition manifests with a number of symptoms that usually disappear within 10 to 15 minutes of eating something sugary. There are, however, different types of hypoglycaemia, some easier to diagnose than others – reactive hypoglycaemia is one of the more tricky ones to definitively identify. It is thought that reactive hypoglycaemia is the precursor for type 2 diabetes mellitus. A common but serious type of reactive hypoglycaemia, termed hyperinsulinaemia, invariably results in type 2 diabetes – unless nipped in the bud.

Hypoglycaemia symptoms are common when one fasts, usually dissipating when one eats, but with reactive hypoglycaemia, symptoms can occur from 1 to 4 hours after eating. Be aware that functional hypoglycaemia, which is generally considered idiopathic (of unknown origin), is sometimes also referred to as reactive hypoglycaemia. Diet modification is the best way to treat reactive hypoglycaemia, e.g. choose foods that contain good quality protein, low glycaemic load (GL) carbs, soluble fibre and healthy fats. Eating several small meals per day, every 2 – 3 hours, rather than 3 large meals, helps to keep hypoglycaemia at bay. Cutting out sugary junk food goes without saying. Warning signs to look out for regarding fasting hypoglycaemia include significant hypoglycaemic symptoms that occur 5 or more hours after a meal.

Besides more serious pathology, certain substances, such as foods, beverages (including alcohol), and medications can cause hypoglycaemia. Refined and processed foods and beverages, especially those high in sugars and other carbs (junk foods), can significantly disrupt blood sugar levels.

The symptoms of hypoglycaemia also vary widely, depending on whether the condition is mild, moderate or severe, and can range from feeling hungry and jittery, to short-temper and confused, or even lead to coma and death – depending on how low the blood glucose levels drop. The warning signs for both diabetic and non-diabetic hypoglycaemia can be similar.

I hope this answers your question, Katie.


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Dr Sandi Nye
About The Author
- Dr, ND. She is a naturopath with a special interest in aromatic and integrative medicine, and is dual-registered with the Allied Health Professions Council of South Africa (AHPCSA). She serves as editorial board member and/or consultant for various national and international publications, and is in private practice in Pinelands, Cape Town.