The Best Diet for Non-Diabetic Hypoglycemia

A lot can happen to your body when your glucose levels are unbalanced. One of the conditions you can develop when they're too low is hypoglycemia. Although this is usually associated with having diabetes, there is also a type that's non-diabetic hypoglycemia. If you have symptoms of this condition (more on that below!), it's a good idea to monitor blood glucose levels. This is especially helpful around mealtime and while you're sleeping. However, it can be tricky if you don't want to do an invasive finger prick test every time you eat a meal or in the middle of the night when you should be sleeping.

So, what's the solution? There are a few, but one that's less invasive, quick, and accurate is continuous glucose monitoring. You can wear the discreet sensor from a continuous glucose monitor (CGM) on the back of your arm, scan it with your phone, and read and store your glucose results. Yes, it is actually that easy. It's an informed way to alter your diet and lifestyle to lower your glucose levels. If you're wondering about the different types of hypoglycemia, how you can change your diet to manage symptoms, and what the advantages of glucose monitoring are, read on. 

Can a Non-diabetic Have Low Blood Sugar?

The simple answer to this question is yes. Low blood glucose (sugar) can affect people who don't have diabetes as well. Before we go into the hows and whys of it all, remember that there are two types of non-diabetic hypoglycemia:

1. Reactive Hypoglycemia (postprandial hypoglycemia): Blood sugar levels can sometimes drop after eating a meal. This is known as reactive hypoglycemia. It usually occurs within the first few hours following a meal. In some instances, reactive hypoglycemia can be an early sign of diabetes.‍
2. Fasting Hypoglycemia (non-reactive hypoglycemia): This is not related to meals and occurs during a fast or while you're sleeping. Some potential causes of fasting hypoglycemia include specific medications (think: insulin, Beta-blockers, ACE/Inhibitors), excess alcohol, hypercortisolism, hypothyroidism, pregnancy, menopause, pancreatic tumors, or anorexia.

How Do You Define Hypoglycemia?

The glucose level that defines hypoglycemia is variable. Among diabetic people, glucose levels below 70 are considered low. However, among those without diabetes, hypoglycemia is more often described as blood sugar drops <55 mg/dL. Someone affected by a blood sugar drop will experience the symptoms we've mentioned below. 

Some people who do not have diabetes and have glucose readings of less than 70 mg/dL will feel fine. Active people who manage their blood sugar, eat low carbohydrate diets, or fast regularly can see low blood sugar readings without clinical symptoms. In this case, where no symptoms are present, the values are likely fine for the individual, and no action is needed.

If you have any of the symptoms below, it's usually your brain signaling that your glucose is too low. When this happens, your body isn't getting the energy it needs. If you have hypoglycemia, you may experience any of the following symptoms:

• Hunger
• Irritability
• Blurred vision
• Pale skin
• Weakness
• Shakiness
• Excess sweating
• Lightheadedness/dizziness
• Anxiety
• Confusion
• Difficulty speaking
• Headaches
• Inability to concentrate

If you experience symptoms of hypoglycemia, it is vital to discuss them with your doctor. They will be able to help you find the underlying cause and discuss treatment options.

Who Is at Risk of Non-diabetic Hypoglycemia?

Non-diabetic hypoglycemia can affect people for several reasons. However, you are more at risk if you:

• Have a genetic/family history of diabetes.
• Have pre-diabetes.
• Are obese.
• Have other health problems (particularly issues with anorexia, your kidneys, adrenal glands or pituitary glands, or pancreas).
• Have had a specific type of stomach surgery, including some bariatric surgeries like gastric bypass surgery.
• Take medication for kidney disease.
• Drink excessive amounts of alcohol.

What Is the Treatment for Non-diabetic Hypoglycemia?

When diagnosing non-diabetic hypoglycemia, a doctor will look through your medical history and conduct several blood tests. If they suspect reactive hypoglycemia, they may recommend a mixed-meal tolerance test or MMTT. During an MMTT, you will have to consume a drink that contains protein, fats, and sugar. You'll also undergo blood glucose level checks several times over the following two to five hours.

If your doctor suspects non-reactive hypoglycemia due to a medical condition or medication, they'll address this root cause. For example, if it is medication-related, your doctor might make changes to your prescription. Medical treatment is not usually required for reactive hypoglycemia, and dietary or lifestyle changes are recommended to lessen the symptoms. If you have severe hypoglycemia or hypoglycemia related to diabetes, you may need medication to manage your blood glucose. And if you have severe symptoms, your doctor may also advise you to carry glucose tablets or injectable glucose (glucagon).

What Is the Hypoglycemic Diet?

Now that you know what hypoglycemia is and how to check for symptoms let's go over what you can change in your daily life to manage it. While you may sometimes get recommendations for a high-protein, low-carbohydrate diet, this type of diet has not been proven to help hypoglycemia. While there's no one size fits all when it comes to diets, some of these dietary changes may be able to help:

• Eat small meals and snacks throughout the day: It's a good idea to space these out to a meal or snack approximately every three hours. This helps to regulate the amount of glucose in your bloodstream. However, this is not suitable for everyone. It's worth trying it to see how it affects you. For some people, limiting carbohydrates is a more successful method, allowing you to go longer between eating without having symptoms of hypoglycemia.‍
• Make sure your diet consists of various foods: This should include protein (meat and non-meat), dairy, and high fiber but low carbohydrate foods, like non-starchy vegetables. Whole grain and high-fiber foods take longer to break down, keeping your blood glucose levels more consistent.‍
• Limit high-sugar foods: Sugar usually doesn't do anyone too many favors. To avoid blood sugar spikes, limit the amount you consume. You don't have to cut it out altogether, but remember that if you have something sweet, it's a good idea to eat it with a meal.‍
• Limit or avoid alcohol: Excess drinking can cause hypoglycemic symptoms. When you drink alcohol, avoid mixing it with sugary drinks, and remember to drink it with food since that will help your stomach absorb it slowly. ‍
• Limit your caffeine intake: Caffeine can cause an increase in adrenaline, which can mimic the symptoms of hypoglycemia. It's a good idea to wean yourself off the dependency so you can enjoy a little caffeine once in a while without too many glucose spikes.‍
• Choose the right carbohydrates: This is essential to managing your blood glucose levels. Carbohydrates can have a low or high glycemic index. If you don't already know, the glycemic index measures how much the carbohydrate raises your blood glucose levels and how quickly it does this. Eating foods with a low glycemic index may help control blood sugar levels. So, when you're picking the carbohydrates you want to eat, choose low glycemic index options. Aim for two to four servings at each meal (30-60 grams) and one to two servings (15-30 grams) as a snack. Of course, none of this is written in stone. Everyone has a unique response to carbohydrates, but you can find out what yours is with the help of a CGM. ‍
• Include protein, fat, and fiber in all your meals: All these components reduce the possibility of steep spikes in blood glucose after a meal.

What to Eat When You Have a Hypoglycemic Event

If you have a hypoglycemic event and can monitor blood glucose levels, you can follow something known as the 15:15 rule. Here's how to do it in four easy steps:

1. Consume 15 grams of glucose/carbohydrates. This can be in the form of a glucose tablet, glucose gel tube, 1 tablespoon of sugar or honey, or a few hard candies‍. 
2. Wait for 15 minutes.
3. Measure your blood glucose levels. 
4. Repeat this treatment until your blood glucose levels reach at least 70 mg/dL.

If you're experiencing symptoms and can't measure blood glucose, it's a good idea to consume fast-acting carbohydrates. These are simple sugars with little to no fiber, like the suggestions above. Other options include fruits like bananas, grapes, apple sauce, dates, or raisins.

When experiencing a hypoglycemic event, it's best to avoid high-fat foods like chocolate or cookies. They don't raise blood sugar quickly enough, as the fat can delay how quickly your body absorbs the required sugar. 

Remember, these are just band-aids and provide a short-term fix for hypoglycemia. If you're looking for a way to address the root cause, and prevent further attacks, consider using a CGM.

What Is the Best Food to Eat When Your Blood Sugar Is Low?

If you suffer from frequent hypoglycemia, it's best to try and avoid low blood sugar by carrying a snack with you at all times. Make sure you don't go long periods without eating. Snacks such as granola bars with protein or nuts, trail mix, and dried fruits are good portable snacks to carry with you.

A Hypoglycemia Food List

Choosing low glycemic index foods can help you control your blood glucose levels. Something to remember when you're planning your meals: meat and fish don't have a glycemic index. This is because they do not contain carbohydrates. 

Foods containing carbohydrates have low, moderate, and high glycemic index options. Here's a breakdown of a few of these, just to give you an idea of the best types of foods to choose from:

Bread

Low GI: Spelt bread, sourdough bread, whole grain tortilla, heavy-mix grain bread. 

Moderate GI: Chapati, linseed bread, flaxseed bread, pita bread, pumpernickel bread, roti, rye bread, whole-grain wheat bread.

High GI: White and whole wheat bread, naan bread.‍

Cereals

Low GI: All-bran, oat-bran, steel-cut oats.

Moderate GI: Instant, quick, or large-flake oats.

High GI: Cornflakes, Rice Krispies, Puffed Wheat, Cream of Wheat, Special K.

Grains

Low GI: Barley, bulgur, firm/al dente pasta, quinoa, pulse flours, mung bean noodles.

Moderate GI: Basmati rice, brown rice, cornmeal, couscous, rice noodles, wild rice, short/long-grain white rice.

High GI: Jasmine rice, millet, sticky rice, instant white rice.‍

Other starches

Low GI: Peas, popcorn, sweet potato, winter squash. 

Moderate GI: Beets, corn, parsnip, potato, rye crackers.

High GI: Carrots, instant mash potato, pretzels, rice cakes, soda crackers.‍

Fruits

Low GI: Apple, apricot, unripe/green banana, berries, cantaloupe, grapefruit, honeydew melon, mango, orange, peach, pear, plum, pomegranate, prunes.

Moderate GI: Ripe banana, cherries, cranberries, figs, grapes, kiwi, lychee, pineapple, raisins.

High GI: Brown/overripe banana, watermelon.‍

Milk and yogurt

Low GI: Almond milk, 1% and 2% cow's milk, frozen yogurt, Greek yogurt, soy milk, yogurt.

Moderate GI: N/A

High GI: Rice milk.

Beans, peas, and lentils

Low GI: Baked beans, chickpeas, kidney beans, lentils, mung beans, romano beans, soybeans/edamame, split peas

Moderate GI: Ready-made lentil or split pea soup

High GI: N/A

Alongside low glycemic index foods, you can also consider:

• High-quality protein (meat, fish, or eggs).
• Alternative sweeteners such as Stevia instead of sugar.
• Fresh vegetables, especially dark leafy greens

Does Exercise Help Reactive Hypoglycemia?

Exercise is always a good thing, so a broad answer to that question is yes, it can help. However, it's important to remember that if you frequently experience hypoglycemia, you may need to adjust your diet slightly depending on your exercise regime. For some people, strenuous or sustained physical activity can cause blood glucose levels to drop. 

The best way to manage this is to eat a small snack containing carbohydrates and protein before exercising. Keep the snack small, and remember to stay hydrated with plenty of water throughout your physical activity. Examples of pre-exercises snacks include:

• Greek yogurt and berries.
• A small amount of mixed dried fruits and nuts.
• An apple and some peanut butter.

Monitoring Blood Glucose Levels Can Help Manage Hypoglycemia

Diet, exercise, lifestyle choices, medication, and medical conditions can affect blood glucose levels. So, it's a good idea to track all of these, rather than just one or the other. An easy way to do this is to get a CGM, an efficient and effective way to monitor and control blood glucose levels for people with or without diabetes. Wearing a CGM may be especially helpful when you're trying to reduce the risk of hypoglycemia. 

Want to take the next step and see what it can do for your health? Try the NutriSense Continuous Glucose Monitoring Health Program to get a continuous glucose monitor (CGM) that gives you real-time feedback. The program also has an innovative app to manage and store the data and connects you with a registered dietitian to help you understand it all.