How to manage hypoglycaemia?

Q: I have been suffering from low blood sugar for the last 3 years. The sugar level tested every 6 months, during GTT (1.25 gm/kg) show fasting: 84 mg%, 1 hr: 103 mg%, 2 hr: 80 mg%, 3 hr: 82 mg%, 4 hr: 93 mg%. After 4 hours, experienced severe palpitations, anxiety, confusion and sweating. Two years back, 36 hrs fasting test showed 67 mg/dl and the insulin level 8 miu/ml. At present I feel very weak, anxious and confused most of the times. I am married with two children, physically active, stressful job and consume alcohol 120 ml 3 to 4 times a week. I do not smoke. I request your expert opinion.

A:In my opinion you are suffering from reactive hypoglycaemia (low sugars few hours after meals) but its important that you undergo prolonged fasting test (72 hrs under supervision of an endocrinologist) to rule out diseases causing low sugars due to increased insulin from pancreas like insulinoma. In case test is negative then you need to take low glycaemic index meals more frequently i.e., small snacks two hours after major meals.