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Evaluation of Postprandial Symptoms

F. John Service, MD
JAMA. 1984;252(10):1281. doi:10.1001/jama.1984.03350100015013.
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To the Editor.—  Chalew et al1 are to be congratulated for their efforts to solve the riddle of patients with nonspecific postprandial symptoms. They confirm observations by others that neither the postoral glucose plasma glucose nadir nor the "hypoglycemic index" can be correlated to the presence of symptoms during the oral glucose tolerance test (OGTT). However, it is difficult to assess the significance of the epinephrine results since eight patients, who presumably had postprandial symptoms, were excluded from analysis because of the absence of signs at the OGTT glucose nadir. The 19 patients who made up the study, therefore, were those with nonspecific symptoms postprandially who had reproduction of their symptoms and signs following oral glucose. They should be designated as having "idiopathic postoral glucose syndrome" rather than "idiopathic postprandial syndrome." In addition, interpretation of the epinephrine responses would require control studies consisting of sham OGTTs and measurement of


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