Failure to Induce Reactive Hypoglycaemia by Drinking a Starch-Based Alcohol Beverage (Sorghum Beer)

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Abstract
Alcohol is a well-recognised cause of fasting hypoglycaemia but may also provoke reactive hypoglycaemia when drunk together with a carbohydrate mixer. In this study the ability of sorghum beer (an ‘in-built’ alocohol-starch beverage widely enjoyed in Southern Africa) to induce reactive hypoglycaemia was compared with ‘gin and tonic’ in eight non-obese healthy African men. After an overnight fast, each subject drank, in random sequence on three different occasions, 2 litres of sorghum beer (carbohydrate content approximately 5% and alcohol concentration 2·24 g/dl–2·8% v/v), the same volume of a control solution providing a similar carbohydrate load, or a gin and standard tonic water mixture. No evidence of reactive hypoglycaemia was apparent during the 5 hours after the beginning of the sorghum beer tolerance tests, despite a mean peak blood alcohol level reaching 80 mg/dl. Both the peak and total plasma insulin responses were significantly reduced (p≤0·05) when compared to the brisk responses elicited by the carbohydrate solution alone and the gin and tonic drinks, with consequent hypoglycaemia. These data suggest that African home-brews are not potent causes of reactive hypoglycaemia, although they may be implicated in the development of ethanol-induced hypoglycaemia in the fasting state.