J Clin Endocrinol Metab. 1994 Nov;79(5):1428-33. 

          Suspected postprandial hypoglycemia is associated with
          beta-adrenergic hypersensitivity and emotional distress.
          Berlin I, Grimaldi A, Landault C, Cesselin F, Puech AJ.
          Departement de Pharmacologie Clinique, Hopital
          Pitie-Salpetriere, Paris, France.

          Suspected postprandial (reactive or idiopathic) hypoglycemia is
          characterized by predominantly adrenergic symptoms appearing
          after meals rich in carbohydrates and by their rare association
          with low blood glucose level (< 2.77 mmol/L). We studied heart
          rate, blood pressure, plasma insulin, C-peptide, and
          catecholamine responses during a 5-h oral glucose tolerance
          test in eight patients with suspected postprandial hypoglycemia
          and eight age-, sex-, and body mass index-matched healthy
          controls. We also evaluated beta-adrenergic sensitivity by
          using the isoproterenol sensitivity test. Psychological profile
          was assessed by the Symptom Checklist (SCL-90R) self-report
          symptom inventory. Patients with suspected postprandial
          hypoglycemia had higher beta-adrenergic sensitivity (defined as
          the dose of isoproterenol required to increase the resting
          heart rate by 25 beats/min) than controls (mean +/- SEM, 0.8
          +/- 0.13 vs. 1.86 +/- 0.25 microgram isoproterenol; P = 0.002).
          After administration of glucose (75 g) blood glucose, plasma
          C-peptide, plasma epinephrine, and plasma norepinephrine
          responses were identical in the two groups, but plasma insulin
          was higher in the patients (group effect, P = 0.02; group by
          time interaction, P = 0.0001). Both heart rate and systolic
          blood pressure were significantly higher (but remained in the
          normal range) after glucose administration in patients with
          suspected postprandial hypoglycemia than in controls (group by
          time interactions, P = 0.004 and 0.0007, respectively). After
          glucose intake, seven patients had symptoms (palpitations,
          headache, tremor, generalized sweating, hunger, dizziness,
          sweating of the palms, flush, nausea, and fatigue), whereas in
          the control group, one subject reported flush and another
          palpitations, tremor, and hunger. Analysis of the SCL-90R
          questionnaire revealed that patients had emotional distress and
          significantly higher anxiety, somatization, depression, and
          obsessive-compulsive scores than controls. We may conclude that
          patients with suspected postprandial hypoglycemia have normal
          glucose tolerance, increased beta-adrenergic sensitivity, and
          emotional distress.

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