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Reactive Hypoglycemia
Test fast 72 hours
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<blockquote data-quote="Brunneria" data-source="post: 2118496" data-attributes="member: 41816"><p>Here is a link you may find interesting.</p><p><a href="http://www.endobible.com/investigation/supervised-72-hour-fast/" target="_blank">http://www.endobible.com/investigation/supervised-72-hour-fast/</a></p><p>As described here, the 72 hour fast is not to diagnose RH, since it does not start with a glucose tolerance test.</p><p>Diabetes is not diagnosed by low blood glucose.</p><p>So the 72 hour fast is to diagnose non-reactive hypoglycaemia, which may have a number of causes.</p><p></p><p>The 5 hour glucose tolerance test is useful in diagnosing insulinomas</p><p><a href="https://www.ncbi.nlm.nih.gov/pubmed/2096054" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/2096054</a></p><p>and in diagnosing RH</p><p><a href="https://www.medscape.com/answers/122122-6343/what-is-the-role-of-oral-glucose-tolerance-testing-in-the-diagnosis-of-hypoglycemia-low-blood-sugar" target="_blank">https://www.medscape.com/answers/122122-6343/what-is-the-role-of-oral-glucose-tolerance-testing-in-the-diagnosis-of-hypoglycemia-low-blood-sugar</a></p><p>however there seems to be quite a variation in the level at which different health care teams diagnose these things.</p><p><a href="https://www.hindawi.com/journals/crim/2013/273957/" target="_blank">https://www.hindawi.com/journals/crim/2013/273957/</a></p><p><em>There has been considerable debate regarding the level of glucose that defines hypoglycaemia, and this has ranged between 2.2 mmol/L and 4.0 mmol/L [<a href="https://www.hindawi.com/journals/crim/2013/273957/#B3" target="_blank">3</a>].</em></p><p></p><p>My own view is that the test results have very limited usefulness where RH is concerned (and incredibly valuable usefulness in diagnosing other conditions).</p><p>They may give handily comparable test results for health care professionals to base clinical RH diagnosis on, but in real life... totally different story.</p><p></p><p>In my case, a 75g glucose test will produce a very different result from a 75g mixed meal test, or a test containing gluten, or a test containing rice rather than glucose.</p><p></p><p>Since I live in a world where I do not <strong><em>ever </em></strong>drink 75g glucose on an empty stomach and then sit around waiting for a hypo, I think the OGTT is a waste of my time, and will not willingly ever have another test.</p><p></p><p>On the other hand, I can replicate RH hypos from 15g of gluten containing carbs, or prevent one by eating those 15g carbs <strong><em>without </em></strong>gluten and with a protein/fat meal. For me, real life trumps the laboratory every time, and I have no intention of chasing a diagnosis when a simple diet adjustment (in my case, gluten free low carb) can keep me well and not in need of that diagnosis.</p></blockquote><p></p>
[QUOTE="Brunneria, post: 2118496, member: 41816"] Here is a link you may find interesting. [URL]http://www.endobible.com/investigation/supervised-72-hour-fast/[/URL] As described here, the 72 hour fast is not to diagnose RH, since it does not start with a glucose tolerance test. Diabetes is not diagnosed by low blood glucose. So the 72 hour fast is to diagnose non-reactive hypoglycaemia, which may have a number of causes. The 5 hour glucose tolerance test is useful in diagnosing insulinomas [URL]https://www.ncbi.nlm.nih.gov/pubmed/2096054[/URL] and in diagnosing RH [URL]https://www.medscape.com/answers/122122-6343/what-is-the-role-of-oral-glucose-tolerance-testing-in-the-diagnosis-of-hypoglycemia-low-blood-sugar[/URL] however there seems to be quite a variation in the level at which different health care teams diagnose these things. [URL]https://www.hindawi.com/journals/crim/2013/273957/[/URL] [I]There has been considerable debate regarding the level of glucose that defines hypoglycaemia, and this has ranged between 2.2 mmol/L and 4.0 mmol/L [[URL='https://www.hindawi.com/journals/crim/2013/273957/#B3']3[/URL]].[/I] My own view is that the test results have very limited usefulness where RH is concerned (and incredibly valuable usefulness in diagnosing other conditions). They may give handily comparable test results for health care professionals to base clinical RH diagnosis on, but in real life... totally different story. In my case, a 75g glucose test will produce a very different result from a 75g mixed meal test, or a test containing gluten, or a test containing rice rather than glucose. Since I live in a world where I do not [B][I]ever [/I][/B]drink 75g glucose on an empty stomach and then sit around waiting for a hypo, I think the OGTT is a waste of my time, and will not willingly ever have another test. On the other hand, I can replicate RH hypos from 15g of gluten containing carbs, or prevent one by eating those 15g carbs [B][I]without [/I][/B]gluten and with a protein/fat meal. For me, real life trumps the laboratory every time, and I have no intention of chasing a diagnosis when a simple diet adjustment (in my case, gluten free low carb) can keep me well and not in need of that diagnosis. [/QUOTE]
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