Hypoglycemic symptoms in the absence of diabetes: Pilot evidence of clinical hypoglycemia in young women

Abstract

Aims: Clinical visits of non-diabetic patients reporting hypoglycemic symptoms are common in endocrinology practices, but remain understudied and lack clinical definition and evidence-based recommendations for diagnosis or treatment. Our goal was to pilot test the concordance of hypoglycemic symptoms with low glucose values in young non-diabetic individuals. Methods: We recruited eight individuals who reported regularly experiencing symptoms consistent with hypoglycemia to wear a blinded Dexcom continuous glucose monitor and report symptoms for seven days. We excluded individuals with diabetes or other known causes of hypoglycemia or similar symptoms. Results: Participants were all women with an average age of 29 years. 25% were African American and 25% had obesity. All participants experienced glucose values ≤ 70 mg/dL and half (4/8) experienced glucose ≤ 54 mg/dL for at least 15 min or 3 consecutive readings. Average time between last meal and reported symptoms was 4.4 h. Lower glucose values were significantly associated with higher odds of experiencing hypoglycemic symptoms 1.15 (CI: 1.07–1.24) for every −5mg/dL, (p < 0.001) from mixed effects models for repeated measures adjusted for age, race, and body mass index. All participants also reported engaging in potentially obesogenic behaviors in order to avoid symptoms. Conclusions: Individuals with hypoglycemic symptoms in the absence of diabetes experience clinical hypoglycemia, indicating the need to understand the etiology, behavioral responses, and other health risks that might be associated with this understudied condition. Keywords: Hypoglycemia, Hypoglycemic symptoms, Continuous glucose monitor, Obesity