Reactive hypoglycemia and A-cell ('pancreatic') glucagon deficiency in the adult

Serum glucose, A-cell (IRGA) and total glucagon (IRGT), insulin, growth hormone, cortisol, triiodothyronine, and thyroxine values were measured in the fasting state and in response to oral glucose, intravenously administered arginine, and a meal of pan-broiled ground beef in 31 symptomatic patients and 11 normal subjects. Twenty-four patients and 11 control subjects had normal glucose tolerance (group 1); seven patients had reactive hypoglycemia (group 2). Under all conditions, serum IRGA value was significantly lower in group 2 than in group 1. Glucose, arginine, or meat increased serum IRGT levels. This response did not differ significantly in the two groups, nor did the secretion of the other measured hormones. We conclude that A-cell insufficiency can contribute to reactive hypoglycemia in the adult.