Hypoglycaemia following a mixed meal in eating disorder patients

Objective To describe the incidence of hypoglycaemia, and variables associated with hypoglycaemia, in eating disorder patients following a mixed meal stimulus. Methods Postprandial blood glucose values of patients admitted to a specialist eating disorder hospital for treatment of an eating disorder between 2000 and 2006 were reviewed and compared to body mass index (BMI), electrolytes, and weight losing behaviours. Analysis of variance (ANOVA) and stepwise logistic regression were undertaken. Results 22% of patients had postprandial glucose values <= 3.5 mmol/l (63 mg/dl). Only low BMI significantly predicted postprandial hypoglycaemia. Conclusion Clinicians should be aware that postprandial hypoglycaemia is a common finding in eating disorders patients receiving inpatient treatment. As hypoglycaemia is predicted by low BMI, weight restoration is a priority for treatment in patients experiencing hypoglycaemia. Future research should investigate the nutrient composition of refeeding regimens and whether altering the macronutrient composition attenuates the presence of hypoglycaemia. Investigation is warranted in a community sample of eating disorder patients to see if this finding is replicated in non-hospitalised patients.