Postgrad Med J 87:405-409 doi:10.1136/pgmj.2010.107151
  • Original article

Hypoglycaemia following a mixed meal in eating disorder patients

  1. Janice Russell2
  1. 1Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  2. 2Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  3. 3Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Queensland, Australia
  4. 4Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown and Sydney Medical School, University of Sydney, New South Wales, Australia
  1. Correspondence to Susan Hart, Department of Psychiatry, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia; susan.hart{at}
  • Received 2 August 2010
  • Accepted 23 January 2011
  • Published Online First 9 March 2011


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.


  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the ethics committee of The Northside Clinic, The University of Sydney.

  • Provenance and peer review Not commissioned; externally peer reviewed.