Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Effect of fasting on young adults who have symptoms of hypoglycemia in the absence of frequent meals


Background and Objectives:

Among otherwise healthy adults, there is a subgroup of individuals who develop symptoms of hypoglycemia during episodes of food restriction. The aim of the present study was to investigate whether such individuals develop hypoglycemia or react abnormally in other metabolic aspects during a 24-hour fast.

Subjects and Methods:

Ninety medical students were asked if they wanted to participate. Sixteen were selected; none dropped out. A 24-hour fast was performed at a hospital ward. Blood samples and questionnaires were taken at eight specific times.


During the fast, the sensitive group reported significantly higher scores on ‘irritation’ and ‘shakiness’. However, no hypoglycemia occurred and the lowest detected blood glucose concentration was 3.7 mmol/l. There were no differences between the groups in plasma glucose, cortisol, growth hormone (GH), insulin, β-hydroxybutyrate (β-OH) and lactate levels. The blood pressures and heart rates were also similar.


Adults, despite subjective signs of hypoglycemia, can fast without any metabolic or endocrine derangement.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others


  • Brun JF, Fedou C, Mercier J (2000). Postprandial reactive hypoglycemia. Diabetes Metab 26, 337–351.

    CAS  PubMed  Google Scholar 

  • Champe PC, Harvey RA (2005). Lippincott's Illustrated Reviews: Biochemistry. Lippincott, Williams & Wilkins: Philadelphia.

    Google Scholar 

  • Chapman IM, Goble EA, Wittert GA, Morley JE, Horowitz M (1998). Effect of intravenous glucose and euglycemic insulin infusions on short-term appetite and food intake. Am J Physiol 274, R596–R603.

    CAS  Google Scholar 

  • Dahlquist G, Gentz J, Hagenfeldt L, Larsson A, Low H, Persson B et al. (1979). Ketotic hypoglycemia of childhood – a clinical trial of several unifying etiological hypotheses. Acta Paediatr Scand 68, 649–656.

    Article  CAS  Google Scholar 

  • Elimam A, Horal M, Bergstrom M, Marcus C (1997). Diagnosis of hypoglycaemia: effects of blood sample handling and evaluation of a glucose photometer in the low glucose range. Acta Paediatr 86, 474–478.

    Article  CAS  Google Scholar 

  • Gielkens HA, Verkijk M, Lam WF, Lamers CB, Masclee AA (1998). Effects of hyperglycemia and hyperinsulinemia on satiety in humans. Metabolism 47, 321–324.

    Article  CAS  Google Scholar 

  • Grunt JA, McGarry ME, McCollum AT, Gould JB (1970). Studies of children with ketotic hypoglycemia. Yale J Biol Med 42, 420–438.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hagstrom-Toft E, Bolinder J, Ungerstedt U, Arner P (1997). A circadian rhythm in lipid mobilization which is altered in IDDM. Diabetologia 40, 1070–1078.

    Article  CAS  Google Scholar 

  • Haymond MW, Howard C, Ben-Galim E, DeVivo DC (1983). Effects of ketosis on glucose flux in children and adults. Am J Physiol 245, E373–E378.

    CAS  PubMed  Google Scholar 

  • Horal M, Ungerstedt U, Persson B, Westgren M, Marcus C (1995). Metabolic adaptation in IUGR neonates determined with microdialysis – a pilot study. Early Hum Dev 42, 1–14.

    Article  CAS  Google Scholar 

  • Inoue K, Kakehashi Y, Oomori S, Koizumi A (2004). Biochemical hypoglycemia in female nurses during clinical shift work. Res Nurs Health 27, 87–96.

    Article  Google Scholar 

  • Kamel A, Norgren S, Persson B, Marcus C (1999). Insulin induced hypoglycaemia: comparison of glucose and glycerol concentrations in plasma and microdialysate from subcutaneous adipose tissue. Arch Dis Child 80, 42–45.

    Article  CAS  Google Scholar 

  • Karam JH (2001). Hypoglycemic disorders. In: Greenspan FS and Strewler GJ (eds). Basic & Clinical Endocrinology. Appleton & Lange: Stamford, CT, USA, pp 823.

    Google Scholar 

  • Levin F, Edholm T, Schmidt PT, Gryback P, Jacobsson H, Degerblad M et al. (2006). Ghrelin stimulates gastric emptying and hunger in normal-weight humans. J Clin Endocrinol Metab 91, 3296–3302.

    Article  CAS  Google Scholar 

  • Marcus C (2001). How to measure and interpret glucose in neonates. Acta Paediatr 90, 963–964.

    Article  CAS  Google Scholar 

  • Marks V (1987). Glycaemic stability in healthy subjects: fluctuations in blood glucose Concentration During the Day. In: Andreani D, Marks V and Lefebvre PJ (eds). Hypoglycemia. Raven Press: NY, USA, pp 19–24.

    Google Scholar 

  • Meyer EL, Waldenlind E, Marcus C (2003). Diminished nocturnal lipolysis in cluster headache: a sign of central sympathetic dysregulation? Neurology 61, 1250–1254.

    Article  CAS  Google Scholar 

  • Sasaki M, Mogi T, Wada Y, Hirosawa I, Koizumi A (1996). An endemic condition of biochemical hypoglycemia among male volunteers. Ind Health 34, 323–333.

    Article  CAS  Google Scholar 

  • Wiesli P, Brandle M, Zapf J, Seiler H, Zwimpfer C, Spinas GA et al. (2004). Assessment of hyperinsulinaemia at the termination of the prolonged fast. Clin Chim Acta 342, 227–231.

    Article  CAS  Google Scholar 

  • Wiesli P, Schwegler B, Schmid B, Spinas GA, Schmid C (2005). Mini-mental state examination is superior to plasma glucose concentrations in monitoring patients with suspected hypoglycaemic disorders during the 72-hour fast. Eur J Endocrinol 152, 605–610.

    Article  CAS  Google Scholar 

  • Wildenhoff KE (1970). A micro-method for the enzymatic determination of acetoacetate and 3-hydroxybutyrate in blood and urine. Scand J Clin Lab Invest 25, 171–179.

    Article  CAS  Google Scholar 

  • Williams G, Cai XJ, Elliott JC, Harrold JA (2004). Anabolic neuropeptides. Physiol Behav 81, 211–222.

    Article  CAS  Google Scholar 

  • Yager J, Young RT (1974). Non-hypoglycemia is an epidemic condition. N Engl J Med 291, 907–908.

    Article  CAS  Google Scholar 

Download references


This work was supported by the Freemasons in Stockholm Foundation for Children's Welfare and the Swedish Research Council #K2002-72X-009941-11B.

Author information

Authors and Affiliations


Corresponding author

Correspondence to J Alkén.

Additional information

Contributors: CM has contributed to the initiation of the study, designed the study protocol, participated in the writing of the manuscript and has been the supervisor of the study. EP has contributed to the study design and participated in the data collection. JA has contributed in all parts of the study

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alkén, J., Petriczko, E. & Marcus, C. Effect of fasting on young adults who have symptoms of hypoglycemia in the absence of frequent meals. Eur J Clin Nutr 62, 721–726 (2008).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


This article is cited by


Quick links