Correct Medical Terminology for Reactive Hypoglycemia
The correct medical term for reactive hypoglycemia is "postprandial reactive hypoglycemia" (PRH), which refers to hypoglycemia occurring 2-5 hours after food intake. 1, 2
Terminology and Classification
Postprandial reactive hypoglycemia (PRH) is the preferred and most accurate medical term, emphasizing the temporal relationship to meals 1, 2
The term "reactive hypoglycemia" itself remains acceptable and widely used in clinical practice, distinguishing it from fasting hypoglycemia 3
The outdated term "functional hypoglycemia" should be avoided as it contributes vagueness and lacks diagnostic precision 3
Clinical Subtypes of Reactive Hypoglycemia
PRH manifests in three distinct temporal patterns 1:
- Idiopathic reactive hypoglycemia: occurs at 180 minutes (3 hours) post-meal 1
- Alimentary reactive hypoglycemia: occurs within 120 minutes (2 hours), typically seen after gastrointestinal surgery 1, 3
- Late reactive hypoglycemia: occurs at 240-300 minutes (4-5 hours), associated with insulin resistance and may predict future diabetes 1
Diagnostic Criteria
True reactive hypoglycemia requires documented plasma glucose <55-60 mg/dL (<3.0-3.3 mmol/L) occurring simultaneously with sympathetic or neuroglycopenic symptoms 1, 2, 4
This corresponds to Level 2 hypoglycemia in the American Diabetes Association classification system, defined as glucose <54 mg/dL (<3.0 mmol/L) 5
Symptoms must resolve with glucose administration or food intake to confirm the diagnosis 6, 2
Important Clinical Caveat
A low glucose value during an oral glucose tolerance test (OGTT) alone is NOT sufficient to diagnose reactive hypoglycemia due to high false-positive rates 2, 4. The diagnosis requires documentation of hypoglycemia during spontaneous symptomatic episodes in the patient's natural environment 6, 3.