Diagnosis of Nonhypoglycemia

To the Editor: The continued awareness of hypoglycemia by the lay public has prompted a recent policy statement by the American Diabetes Association.¹ The problems involved in the correct diagnosis of reactive (postprandial) hypoglycemia by oral glucose-tolerance testing and the concept of “non-hypoglycemia” as “non-disease” have been reviewed in the Journal.²,³ The physician who encounters a patient with the misattribution of hypoglycemia for a symptom complex must handle the situation diplomatically but firmly. A test meal or a placebo “glucose“-tolerance test has been used to confront the patient with the lack of evidence of a diagnosis of hypoglycemia.⁴,⁵ The.