Different Types of Hypoglycemia – Different Treatment


Many people don’t realize that there are different types of hypoglycemia, and therefore, very different treatment options. Let’s talk about the more common one first, medication induced hypoglycemia.

Medication Induced Hypoglycemia

For insulin dependent diabetes (Type 1 and Type 2), there is a greater chance of hypoglycemia due to the imperfect science of matching insulin to carbs. The more carbs we eat, the greater doses of insulin are needed. This INCREASES the chances of hypoglycemia. The BEST way to reduce this type of hypoglycemia is to reduce carbs, which will reduce insulin usage, which will lessen the chance of hypoglycemia. (See Dr. Bernstein’s “Law of Small Numbers” HERE). Despite a controlled low carb diet however, people with Type 1 will still experience occasional hypoglycemia. Glucose tablets are the optimal treatment for this type of hypoglycemia, as noted in this link I posted earlier this week. (HERE)

(For those with Type 2 that are insulin dependent, adopting a low carb approach and getting vigorously active is the best way to reduce or eliminate insulin usage. I highly recommend those with insulin dependent Type 2 to pursue this remedy.  Type 2 is reversible for most people.  Reversing diabetes should be the primary goal for those with Type 2.)

Now let’s talk about a hypoglycemia that has NOTHING to do with medication. This type of hypoglycemia can be experienced by those Type 2 on NO insulin (and no meds that increase insulin.) More often, it is happening to those with pre-diabetes, people who don’t know they have pre-diabetes, and people who will soon have pre-diabetes or type 2…those on the road to Type 2. It is called “reactive hypoglycemia.”

Reactive Hypoglycemia

Why is it called “reactive.” Because our body is typically reacting to a stimulus…something we typically have done. Here’s how it goes. Most of you that follow this page already understand that Type 2 diabetes is a condition of too much insulin for many years, even decades leading up to a diagnosis. The most common factor that causes the high insulin levels is poor diet (too many processed and refined sugar and carbohydrates) and poor lifestyle habits (lack of sleep, sedentary, uncontrolled stress, medications, etc). We call high insulin levels hyperinsulinemia (literal translation:  hyper = too much / insulin / EEMIA=because we have to make it sound complicated…😜)


When a person with hyperinsulinemia eats a meal loaded with carbohydrates, the body will try to match this carbohydrate load with insulin. But remember, the body was never designed to make these huge doses of insulin, and often, the body overshoots the target, making too much insulin. This causes blood sugar to fall rapidly after a meal. A person can start to feel symptoms of hypoglycemia even when their blood sugar is still high due to the rapid rate that the blood sugar is dropping. Eventually, the blood sugar really will go low, lower than it was before the meal. Most people at this point are craving more carbs to bring the blood sugar back up again.


This is a vicious cycle that can only be stopped with a healthy diet low in carbohydrates. The source of carbohydrates is also important. The carbs that one DOES consume on a low carb diet should NOT be sugar or refined carbs, but rather, carbs derived from real, whole, unprocessed foods (non-starchy vegetables, etc)

As an adult with first diagnosis of pre-diabetes at 40, I can say that I can remember bouts of (reactive) hypoglycemia in my late teens and 20s. I didn’t know what it meant but I knew that if I drank juice, it went away…for a while…I wish I would have known the path I was on and what to do about it.

So for ALL types of hypoglycemia, the best treatment is a low carb, whole food diet. Getting active is also a great tool, as it improves insulin sensitivity. For those that inject insulin, that means you will need less. For those that make all of their own insulin, it means the body will need to make less.

Finally, if you take insulin (or medications that increase insulin), and have frequent hypoglycemia even with your healthy lifestyle, it’s time for a chat with your healthcare provider to discuss reductions in medication.

Be safe and be well 😉

(This article does not discuss other disorders of hyperinsulinism.)