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The clinical evaluation and the results of oral glucose tolerance tests in patients with alimentary hypoglycemia, reported previously or studied as part of our group of 24 patients with this disorder, suggest that alimentary hypoglycemia may differ from other reactive hypoglycemias in clinical presentation and importance. Unlike other reactive hypoglycemias, alimentary hypoglycemia may be associated with severe or permanent neuropsychiatric complications. Subtle, "neuroglycopenic" symptoms of hypoglycemia may occur, instead of "typical," "adrenergic" symptoms. Glucose ingestion, by causing early hyperglycemia and provoking the release of insulinotropic enteric hormones appears responsible for this disorder. Therefore, therapy with diets low in simple sugar, but unrestricted in complex carbohydrate and fiber are now advocated.
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