Hello everyone I'm new here and I look for your advise if I may have reactive hypoglycemia and what is the cause of it. I have read that lean women with PCOS often have it, along with high insulin, and 70% of them may have insulin resistance. I'm not diagnosed with PCOS but have had all symptoms all my life. However, I'm not sure I have insulin resistance because my fasting insulin seems very low. I calculated HOMA-IR and QUICKI based on my fasting glycose and insulin, and the result is insulin sensitive. My HbA1 is 5.3. However, considering that I've been on sugar free, low GI diet for decades, my fasting sugar seems a bit on high side. Since my childhood and especially since teenager I've have bad reaction to carbs, especially high GI and sugar, about 2 hours after meal I get all hypo symptoms, so I've not eaten these foods for decades. My endo said 2 h GGT test results were normal, but 3 hours after test I almost collapsed (trembling, sweat, hunger, dizzy, etc.) and I felt weak even on the next day. Therefore, I'm not willing to take an extended GGT for 4-5 hours, because this experience was terrible. My main question is: doctors diagnose reactive hypo by postprandial glycose 3 mmol/l; anything above this level is not considered hypo. However, 2 h GGT shows that my glycose is lower at 2nd hour (4 mmol/l) than fasting (5,3 mmol/l). In addition, I am sure at 3rd hour it was even lower - because I developed the worse symptoms after I left the hospital, at home. Are these results enough to say I have reactive hypo, and why did my endo said the "test was normal" and I don't have insulin resistance and glycose intolerance? Given that my fasting insulin is low, what is the mechanism that it spikes at hour 2 and 3 after 75 ml oral glycose? Does this lead to insulin resistance in the future? I'm now on paleo, light keto - trying to transfer to full keto. fS-C-pept reference 298-2350, my results: 394 pmol/l Fasting glycose reference <6,1, my results: 5,3 mmol/l After 2 hours reference <7,8, my results: 4,0 mmol/l Fasting S-Ins reference < 29,1, my results: <2,00 mIU/l Thank you!