Can people without diabetes have low blood sugar?

Yes, but it is rare and always abnormal. The body has multiple safety mechanisms to prevent hypoglycemia.

Types:

• Reactive (Postprandial) Hypoglycemia: Blood sugar drops 2-4 hours after eating. Common after bariatric surgery or in people with early Type 2 Diabetes.
• Fasting Hypoglycemia: Occurs after prolonged fasting (8+ hours). This is more concerning and often points to a serious medical issue.

Causes of Fasting Hypoglycemia:

• Insulinoma: A tumor in the pancreas that makes too much insulin.
• Medications: Accidental or intentional overdose of insulin or sulfonylureas.
• Alcohol: Blocks the liver from releasing glucose.
• Adrenal Insufficiency or Hypopituitarism: Hormone deficiencies.
• Severe Liver or Kidney Disease.

Diagnosis:

Doctors look for "Whipple's Triad":

1. Symptoms of hypoglycemia.
2. Low blood glucose (<55 mg/dL) measured at the time of symptoms.
3. Resolution of symptoms when glucose is raised.

A supervised prolonged fast (up to 72 hours in the hospital) with frequent bloodtests may be needed to catch the low and measure insulin levels.

Treatment:

Depends on the cause. Insulinomas are usually cured with surgery.