An update on reactive hypoglycemia.

Reactive hypoglycemia usually occurs in response to a carbohydrate load, rather than presenting as fasting hypoglycemia. The clinical picture may be that of excess circulating epinephrine or decreased cerebral cortical function. The principal causes are alimentary, "functional" (a debatable diagnosis) or early diabetes mellitus. The diagnosis is confirmed by simultaneous serum insulin and blood glucose levels and a five-hour oral glucose tolerance test. Simple management regimens are tailored to each type of hypoglycemia.