The fact is that after extensive blood testing, most people with the above recurrent symptoms don't have low blood sugar at all. All of this creates an interesting situation for doctors who, although their patients have definite symptoms, can't find anything wrong by using current laboratory measurements. The patients know, however, that a meal will relieve symptoms. Most people, for example, are not shaky when they get up in the morning, and in fact want a cup of coffee, tea or juice rather than food. When fasting, we utilize storage forms of sugar to maintain our blood glucose in a fairly strict range - approximately 80 to 110 on a standard blood test.
Many folks can eat only once a day without problems.
There might be many people, however, who physically sense a normal shift in blood sugars to the lower end of the standard range. These patients might be sensing metabolic shift toward stored energy which occurs after a certain amount of hours without food. What I find helpful for my patients is to recommend complex carbohydrates as a replacement for simple and refined sugars. Table sugar or even fruit sugar might raise, then drop, blood glucose too quickly. Eating a complex carbohydrate such as brown rice might provide a more steady blood sugar level.