Correct Medical Terminology for Reactive Hypoglycemia
The correct medical term is "postprandial reactive hypoglycemia" (PRH), which specifically describes hypoglycemia occurring 2-5 hours after food intake in the postprandial state. 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" alone is acceptable but less specific, as it encompasses the broader category of meal-induced hypoglycemic disorders 3
The outdated term "functional hypoglycemia" should be avoided, as it contributes vagueness and lacks precision in describing this metabolic condition 3
Clinical Subtypes
PRH manifests in three distinct temporal patterns based on timing after food intake 1:
- Idiopathic reactive hypoglycemia: occurs at 180 minutes (3 hours) post-meal 1
- Alimentary reactive hypoglycemia: occurs within 120 minutes (2 hours), typically seen in patients with gastrointestinal dysfunction 1, 3
- Late reactive hypoglycemia: occurs at 240-300 minutes (4-5 hours), associated with decreased insulin sensitivity and higher diabetes risk 1
Diagnostic Terminology Standards
True reactive hypoglycemia requires documented plasma glucose <55-60 mg/dL (<3.0-3.3 mmol/L) occurring simultaneously with sympathetic or neuroglycopenic symptoms 4, 2
The American Diabetes Association classifies this as Level 2 hypoglycemia when glucose is <54 mg/dL (<3.0 mmol/L) 4
Important Caveat
A common pitfall is confusing "postprandial hyperadrenergic reaction" (which occurs without true hypoglycemia) with genuine postprandial reactive hypoglycemia—the former is much more prevalent but represents a different clinical entity 5