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Reactive Hypoglycemia


Reactive Hypoglycemia
(Low Blood Sugar)

Sugar Blood Level and Behavior

Studies have suggested that habitually violent and impulsive behavior may be connected with reactive hypoglycemic tendencies.  Reactive hypoglycemia can be tested for by using the Oral Glucose Tolerance Test (OGGT).


 

The  OGTT begins with a fasting client ingesting a predetermined amount of sugar water.  Blood sugar levels are established through blood tests repeated every half hour. 

The blue line represents a normal, non-reactive, glucose pattern.  The client starts with a fasting sugar value of between 80 and 90.  The sugar level climes during the first half hour and peaks somewhere around 140.  The body then responds by having the pancreas release insulin (the hormone which is necessary to remove sugar from the blood and place it in storage).  The sugar level then begins to decrease finally leveling out at its starting point in approximately three hours.

The red line is that of a diabetic.  They begin with a fasting sugar level higher then 120.  After ingesting the sugar, the blood sugar begins to rise.  Instead of tapering off at about 140, as with the normal client, it continues to rise and eventually levels off at a significantly elevated level.

The green line shows a similar pattern to the diabetic’s, but does not have the extremes.  This person is considered to be pre-diabetic.

The orange line is that of a reactive hypoglycemic.  They begin with a reasonable fasting blood sugar level.  However, after ingesting the sugar, the blood level rises and often peaks  above 140.  As it passes 140 the body finally begins to react, the pancreas, where insulin is made, secrets insulin into the blood stream and the level of blood sugar begins to fall.  Unfortunately with the reactive hypoglycemic, the pancreas tends to over react causing the blood sugar to drop to a dangerously low level.  If the body allows this to continue death becomes a possibility.

With an increase in sugar, there is a related fall in the calmative neurotransmitter serotonin and an increase in the catecholamines or excitatory neurotransmitter (norepinephrine, epinephrine, and dopamine). And, sensing the falling levels of sugar, the body calls upon the adrenal glands to release catecholamines or excitatory neurotransmitter which in turn causes the liver and muscles to release its stores of sugar (glucose) into the blood stream.  As can be seen from the graph, the reactive hypoglycemic then yo-yos back in forth until stable blood sugar level is finally reestablished. 

Symptomatically, there are two phases to the reactive hypoglycemic's curve:  1. Neuroglycopenic (low blood sugar to the brain) and,  2. Adrenergic (the release of excitatory neurotransmitters by the adrenal glands). Each phase brings with it unique characteristics and reactions.

Neuroglycopenia

Neuroglycopenia simply means "lack of sugar to the brain." The only energy source  the brain can tap into is glucose.  So, when glucose is low, unique and distinctive symptoms can occur  Habitually violent and impulsive persons have peculiar symptoms, especially motor restlessness, nervousness, difficulty in concentrating, diminished feelings of hunger and irritability. These symptoms appear most commonly during this phase.

Adrenergic

Adrenergic indicates the involvement of the adrenal glands and in particular the
neurotransmitter epinephrine.  One of the functions of the sympathetic nervous system is to increase the availability of glucose. When the body senses that the blood sugar levels are getting dangerously low, the sympathetic nervous system stimulates the adrenal medullae to release epinephrine. Epinephrine then travels to the liver and muscles where it activates phosphorylase and thereby causes the rapid release of sugar into the blood stream. Epinephrine, however, also has additional effects upon the body which accounts for many of the symptoms noted in the second phase of the OGTT.

NEUROGLYCOPENIA SIGNS AND SYMPTOMS (lack of sugar to the brain)

Confusion
Drowsiness
Fatigue
Headache
Irritability
Lack of Muscle Coordination
Motor Weakness
Personality Changes
Slowness of Thinking/Concentration
Speech Difficulties
Visual Disturbances

ADRENERGIC SIGNS AND SYMPTOMS (side effects of epinephrine)

Anxiety/Nervousness
Faintness
Inner Trembling
Nausea
Pallor
Restlessness
Sensation of Huger
Sweating
Tachycardia/Palpitations
Trembling
Weakness