BACKGROUND: Reports of postprandial symptoms attributed to hypoglycemia by otherwise healthy individuals appear to be relatively common in UK women. Whether these symptoms are related to blood glucose is a contentious issue, which periodic ambulatory blood glucose measurement has failed to resolve. OBJECTIVE: The authors investigated, using continuous glucose monitoring technology, whether postprandial symptoms are associated with interstitial glucose concentrations (IG) in the hypoglycemic range or with a previous fall in IG. DESIGN: Thirty healthy nonobese women (age 20-48 y) who reported symptoms attributable to hypoglycemia and 20 nonsymptomatic controls wore a subcutaneous probe in abdominal fat for 4-7 d (median: 5 d) and kept a diet and activity diary during this time. RESULTS: Twenty women reported postprandial symptoms; 41 episodes were recorded. When symptomatic, IG was < or =3.3 mmol/L in 5 of cases. A significant fall in IG over the preceding 60 min was observed before autonomic symptoms (P < 0.005). The proportion of total energy intake derived from dietary fat in the symptomatic group was higher than that in the controls (P < 0.05). The proportion of total sugars was similar between groups; however, the meal preceding symptoms had a higher percentage of energy derived from total sugars when compared with the individuals' diet over the study period (P < 0.05). CONCLUSIONS: Most symptoms attributable to hypoglycemia were not associated with an IG concentration in the hypoglycemic range. A previous fall in IG may be implicated in the etiology of autonomic symptoms, with the consumption of meals high in sugars potentially playing a role in symptom initiation.
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