Evidence-Based Nutrition For Chronic Disease Prevention

Blood Sugar Spikes, Reactive Hypoglycemia, and How to Avoid Them: An Interview With Dr. Penny Figure

Published on May 24, 2023

In this video, I am having a conversation with Dr. Penelope ‘Penny’ Figtree, a primar care physician from Port Macquarie on the East Coast of Australia. In her office, she is focussed heavily on using dietary approaches, particularly low-carb diets, to treat obesity, type 2 diabetes, and other metabolic diseases. She also has some unexpected personal experiences with blood sugar spikes, frequently also followed by episodes of reactive hypoglycemia.

In this video, we are discussing the value of continuous glucose monitors to identify which foods lead to blood sugar spikes and reactive hypoglycemia, how such spikes and the following low blood sugar levels can be avoided, and how regular spikes to just one food can even lead to a diagnosis of pre-diabetes if eats eaten regularly.

Connect with Dr. Penny Figtree

Low-Carb Port Macquarie. Dr. Figtree’s office: https://www.lowcarbpmq.com.au

On Facebook: https://www.facebook.com/groups/829022994702336 

Twitter: https://twitter.com/PenelopeFigtree


  1. Wyatt et al.; Postprandial glycemic dips predict appetite and energy intake in healthy individuals. Nature Metabolism 2021; 3: 523-9.
  2. Norwitz et al.; Metabolic health immersion for medical education: a pilot program with continuous glucose monitors in medical and dental students. American Journal of Lifestyle Medicine 2022; ePub ahead of print August 15.
  3. Ludwig et al.; High glycemic index foods, overeating, and obesity. Pediatrics 1999; 103: e26.
  4. Summary of research on normal postprandial blood sugar levels vs. blood sugar spikes, and the impact of blood sugar spikes on chronic disease risks: blog post Blood Sugar Spikes – Q&A  from May 10, 2023.

2 Responses

  1. Critical question- I’m not diabetic nor am I pre-diabetic. But…

    Was it the smoothie in general that spiked blood glucose or was it the ensure product in the smoothie?

    I have a smoothie every morning for last 8 years. I don’t use any kind of powders, just ½ medium banana, ¼ blueberries, greek yogurt with fat, ¼ pear, oz or peanuts or freshly ground peanuts… those kind of ingredients. About 16oz typically but was thinking to reduce to 10oz.

    1. My best guess is that it was the combination of lots of fruit in liquified form plus the starch and sugar from the protein drink. In general, I think people with glucose intolerance should be very careful with ‘liquid’ carbs. If you have this regularly, you may want to check a few times what your blood sugar does when you drink it. You can do this with a hand-held glucose meter as well, as long as you measure a few time points within the first 60-90 minutes after taking the first sip.

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