Idiopathic postprandial syndrome

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Idiopathic postprandial syndrome, colloquially but incorrectly known by some as hypoglycemia (especially in North America), describes a collection of clinical signs and symptoms similar to medical hypoglycemia but without the demonstrably low blood glucose levels which characterise said condition.

People with this condition suffer from recurrent episodes of altered mood and cognitive efficiency, often accompanied by weakness and adrenergic symptoms such as shakiness. The episodes typically occur a few hours after a meal, rather than after many hours of fasting. The principal treatments recommended are extra small meals or snacks and avoidance of excessive simple sugars.

Etymology and history of diagnosis

The term idiopathic postprandial syndrome, which literally translates as a syndrome which occurs after eating (postprandial) and of unknown cause (idiopathic), was coined around 1980 in an attempt to reserve the term hypoglycemia for those conditions in which low glucose levels could be demonstrated.[1] It was offered as a less confusing alternative to functional hypoglycemia and as a less pejorative alternative to "nonhypoglycemia" or "pseudohypoglycemia."

The syndrome resembles reactive hypoglycemia except that low glucoses are not found at the time of symptoms.

Adrenergic postprandial syndrome

There is some evidence of the existence of a so-called "adrenergic postprandial syndrome": the glycemia is normal, and the symptoms are caused through autonomic adrenergic counterregulation.[2] Often, this syndrome is associated with emotional distress and anxious behaviour of the patient.[3][4]

Symptoms

The symptoms include many of the symptoms associated with milder degrees of hypoglycemia, especially the adrenergic symptoms, but do not progress to objective impairment of brain function, seizures, coma, or brain damage.

  • Shakiness
  • Sense of weakness
  • Altered or depressed mood
  • Confusion
  • Fatigue
  • Anxiety
  • Paleness
  • Perspiration
  • Increased pulse or respiratory rate
  • Hunger

See also

References

  1. ↑ Charles MA, Hofeldt F, Shackelford A, et al. (1981). "Comparison of oral glucose tolerance tests and mixed meals in patients with apparent idiopathic postabsorptive hypoglycemia: absence of hypoglycemia after meals". Diabetes 30 (6): 465–70. doi:10.2337/diabetes.30.6.465. PMID 7227659. 
  2. ↑ "postprandiale Hypoglykämie". Archived from the original on 2007-05-22. Retrieved 2007-07-06. 
  3. ↑ Brun JF, Fedou C, Mercier J (2000). "Postprandial reactive hypoglycemia". Diabetes Metab. 26 (5): 337–51. PMID 11119013. 
  4. ↑ Berlin I, Grimaldi A, Landault C, Cesselin F, Puech AJ (1994). "Suspected postprandial hypoglycemia is associated with beta-adrenergic hypersensitivity and emotional distress". J. Clin. Endocrinol. Metab. 79 (5): 1428–33. doi:10.1210/jc.79.5.1428. PMID 7962339. 
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