Hypoglycemia is when your blood sugar falls below typical levels. Whipple triad is a group of three criteria that doctors use to help diagnose hypoglycemia. To treat hypoglycemia, you can take steps to raise blood sugar.
If your blood sugar levels drop low enough, hypoglycemia can lead to symptoms like shakiness and confusion as well as potentially serious health complications like seizures and loss of consciousness.
The term “Whipple triad” refers to three criteria that doctors use to diagnose hypoglycemia. Continue reading to learn more about Whipple triad, what it means, and how to treat hypoglycemia.
To meet the first criterion of Whipple triad, you must have symptoms of hypoglycemia. While not everyone with hypoglycemia will experience symptoms, you’ll start to have them if blood sugar levels drop low enough.
2. Blood sugar levels
You have hypoglycemia when your blood sugar drops below
The Endocrine Society defines three levels of hypoglycemia, based on your blood sugar levels as well as your condition. These are:
- Mild: Blood sugar is less than 70 mg/dL but still higher than 54 mg/dL.
- Moderate: Blood sugar is less than 54 mg/dL.
- Severe: Your level of functioning is greatly reduced due to the physical and mental effects of low blood sugar and you require help from another individual.
So, according to this definition, people who meet the criteria for Whipple triad have moderate to severe hypoglycemia.
The third criterion of Whipple triad involves how hypoglycemia responds to treatment. To meet this, your symptoms must lessen when treatment helps raise your blood sugar levels.
Several symptoms can mean that you have hypoglycemia. The types of symptoms you have can depend on how severe your hypoglycemia is.
If your hypoglycemia is mild to moderate, you may experience:
- increased hunger
- nervousness or anxiety
- dizziness or lightheadedness
- quick heartbeat or heart palpitations
When hypoglycemia becomes severe, you can have:
Insulin tells your body to use or store glucose. Because insulinomas secrete insulin, they can lead to hypoglycemia.
In people with diabetes, hypoglycemia can happen due to:
- too much insulin being taken
- the timing of when you take your insulin
- not enough carbs consumed for the amount of insulin you take
- how much protein, fat, or fiber are in your meals, which can impact absorption of carbs
- irregular meals or skipping meals
- increased levels of physical activity
- excess alcohol intake
While uncommon, hypoglycemia can also affect people who don’t have diabetes. Some potential causes include:
If you have Whipple triad, treatment focuses on reversing hypoglycemia by increasing your blood sugar levels. Indeed, one of the three criteria of Whipple triad is that symptoms start to resolve as blood sugar goes up.
Sometimes your blood sugar levels can be boosted by a sugar- or carb-rich source, such as fruit juice or honey. You continue to consume these foods or drinks until your blood sugar levels return to usual.
The general rule of thumb here is to have 15 grams of carbs every 15 minutes. Simply put, if your blood sugar levels are still low after 15 minutes, you have another 15 grams of carbs. This is called the 15-15 rule.
However, more severe hypoglycemia often cannot be treated using the 15-15 rule. In this situation, other treatment options are necessary, such as:
Although they have similar names, Whipple triad isn’t related to Whipple disease. Whipple disease is a bacterial illness caused by the bacterium Tropheryma whipplei. It was first described by the pathologist George Hoyt Whipple
This bacterium is present in the environment. While it can also be found in the stool samples of 1–11% of healthy people, according to
The symptoms of Whipple disease often include joint pain and digestive symptoms like diarrhea, abdominal pain, and unintended weight loss. Other organ systems can also be affected, which can lead to heart disease, vision loss, or seizures.
Whipple triad is three criteria used to diagnose hypoglycemia. In order to meet the criteria of Whipple triad:
- Symptoms of hypoglycemia are present.
- Blood sugar is below 55 mg/dL.
- Symptoms ease with treatment to raise your blood sugar.
Hypoglycemia can cause potentially serious health complications. If you frequently experience symptoms of hypoglycemia, visit your doctor to discuss steps you can take to manage your blood sugar.