I too did the GTT, but the 2hr, and I did not experience any severe symptoms and my blood sugar levels were normal. The DR. who gave me my results was very dismissive and told me I was fine. The more appropriate test for RH is the 4-6hr test which measures your blood sugar over a longer period of time at regular intervals and is more concerned with rates of change in levels of BS rather than actual levels. Funny how in my case and in the case of the first article you linked to the controlled tests failed to replicate RH. As the article states though, it is "highly individual."

I am not convinced.

From the first article...

"However, scientific studies and anecdotal evidence *suggest* the following recommendations will assist in keeping blood sugar levels more constant ... Once exercise has been initiated for at least 20min, and during prolonged training and racing situations (1hr+ ), the consumption of sports-drinks will drastically reduce the likelihood of hypoglycemia by maintaining blood glucose concentrations."

This is not properly supported and also it does not explicitly say that sports drinks, i.e., sugar, will reduce the likelihood of reactive hypoglycemia, but only hypoglycemia. The references for this article are also dated and if RH is poorly understood today I doubt it was clearly understood 15 years ago.

From the second article ....

"The roles of pre-exercise supplements and carbohydrate feedings during exercise in this context are less clear."

and...

"Because of rapid gastric emptying characteristic of reactive hypoglycemia, it would appear that pre-exercise supplementationmay be of particular value to the hypoglycemic exerciser. Further, recent studies (Bergstrom & Hultman, 1967; Coyle et al., 1983; Foster et al., 1986; Leatt & Jacobs, 1986; Horton, 1988) indicate that carbohydrate solutions taken during exercise are effective in maintaining serum glucose levels and improving endurance performance. Careful monitoring of nutritional factors would appear to be critical in creating a suitable dietary environment for the hypoglycemic endurance exerciser."

Yes eating before exercising is good for the hypoglycemic exerciser. But the second statement merely supports carb loading for endurance performance and not specifically for an athlete with RH. The final statement cautions against such a jump in logic (IMO). I also think one needs to distinguish between RH and incidents of low blood sugar amongst "normal" athletes.

I've not yet read through the final article, but I will.

I first noticed my symptoms when I began power-walking. I started to bring along pieces of chocolate to get me through my walks. At first I wouldn't need to eat a piece until about after an hour, but slowly I needed to eat a piece earlier and earlier. When I couldn't get through 10 minutes of power walking without getting symptoms and needing a piece of chocolate every additional 10 min I thought okay, I need to stop. Something is very wrong here. Also, while at work (as a server) the same pattern was developing. I was unable to stop and eat at work so it was a can of coke that got me through my shift. It was my co-workers who told me that I needed to see a DR. after I would get so dizzy and confused that I would walk into walls. So my theory is that I did it to myself by consuming sugar to ward off hunger and mental and physical fatigue. I essentially created a sugar dependency and broke my system. Yes, this is anecdotal and anecdotal evidence doesn't carry very much scientific weight. However, if anyone wants to try and convince me that carb loading is the answer for getting through physical activities, well it just won't happen. I think it is bad advice - for me. I've been down that road and it wasn't pretty.

I do very much appreciate your feedback, suggestions and links though. I have learned a thing or two reviewing those articles. I welcome your comments.