Anyone know the answer to this?

I have a friend who is sure she has reactive hypoglycaemia. she certainly has all the symptoms and has had for all the 12 years I’ve known her. She can’t get a diagnosis, because when she was tested at the hospital, her fasting blood sugar was 2.7 mmol/l (48.6mg/dl) and apparently it needs to be below 2.5mmol(45mg) Her glucose tolerance test shows a sharp rebound drop on the graph. down to 2.9 within half an hour or so of eating. She finds she can keep going if she eats every 2 hours, otherwise she falls asleep. I read somewhere that reactive hypoglycaemia can respond well to the Atkins diet and on the grounds of “it’s worth a try, because it can’t hurt” .She’s been doing well with that. I also read that reactive hypoglycaemia is related to type 2 diabetes, but without the insulin resistance. There’s so much expertise on this forum, i thought I’d ask if anyone knows about this wierd condition.

I’m curious if she has ever tested earlier than the rebound to see if she is getting any high spikes? I have heard that hypoglycemia can be a precursor to diabetes. I have had it all my life, even as a little girl. If I didn’t eat, I would get shaky and nauseous. I was diagnosed last year and found out that I was going up to 200 or so very briefly, then getting a huge hit of secondary insulin and going down to about 50. It took a while to get the diagnosis (LADA) because I was down in the normal range by an hour. I would keep an eye on post meal BG if I was your friend.

I have a family member with reactive hypoglycemia. The treatment is splitting your food into five smaller meals throughout the day, or three with snacks between, ensuring that each meal/snack has protein, fat and carbs.

I have hyperinsulinemia, sounds similar.
After eating my bg goes down.
I also have to inject B 12 3 times per week , or I fall asleep sitting up in the evenings or afternoons.
Your friend should be more pro active and find an endrocronologist who is willing to be more open to differences in people, and what is normal for one is abnormal for another.