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Her symptoms and investigations warrant that she should be further evaluated at an higher center, despite her family history of obesity. Various diseases need to be screened for her clinical manifestations like;
1) liver disease,
2) endocrine deficiencies,
3) extrapancreatic insulin-producing tumors
4) insulinoma (insulin producing pancreas tumor)
5) Noninsulinoma pancreatogenic hypoglycemia syndrome (NIPHS)
6) Autoimmune hypoglycemia
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Small multiple meals 6-7 times a day will keep her blood sugar from falling and she would feel better. Include fruits like banana and mango in 2-3 servings. Mild exercises like stretching helps. Avoid fatty, fried and junk food. Also avoid colas.
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