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A. Hadji-Georgopoulos, MD
Johns Hopkins University School of Medicine Baltimore

JAMA. 1980;244(23):2608.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The authors of "Reactive Hypoglycemia" (243:1151, 1980) state that "hypoglycemic symptoms occurring during the [oral glucose tolerance] test were not related to level of plasma glucose nadir or to rate of descent of glucose level." Our recently published results¹ support the conclusion that the blood glucose nadir should not be used as the sole criterion for diagnosis.

However, the hypoglycemic index² (defined as the fall in blood glucose level during a 90-minute period before reaching the nadir divided by the value of the glucose nadir) can separate with no overlap symptomatic from asymptomatic patients. The hypoglycemic index correlated with the insulin levels 90 minutes before the lower blood glucose levels. Therefore, an elevated hypoglycemic index is associated with symptoms and reflects later hyperinsulinism. . . . [Full Text PDF of this Article]

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