Be alert to hypoglycemia as a warning signal of diabetes Some diabetic patients have early symptoms not of three more or less, but of hypoglycemia such as unbearable hunger before meals. The main reason for preprandial hunger is that the pancreatic β-cells are unresponsive to early secretion, causing hyperglycemia, which in turn stimulates the pancreatic β-cells and causes hyperinsulinemia, resulting in hypoglycemic reactions such as unbearable hunger 4 to 5 hours after a meal. In normal people, insulin secretion is almost synchronized with blood glucose. When blood glucose rises after meal, insulin secretion increases immediately to keep blood glucose within the normal range; when blood glucose falls, insulin secretion also decreases immediately, which does not cause hypoglycemia. In the early stage of diabetes, the amount of insulin secretion is not significantly reduced, but the delay of peak secretion is not consistent with the blood sugar level, and the insulin secretion cannot increase correspondingly when the blood sugar rises after meals, resulting in excessive blood sugar; before the next meal, the blood sugar comes down, but the insulin secretion just reaches the peak, which causes hypoglycemia and causes unbearable hunger before meals. As the disease progresses, insulin secretion becomes less and less, and this kind of pre-meal hypoglycemia will not happen anymore. Of course, some patients who take oral hypoglycemic drugs or insulin may also suffer from preprandial hypoglycemia because their diet, exercise or medication are not well matched. Most of these patients have a family history of diabetes and are overweight and obese. Treatment generally requires only calorie restriction (mono-diet therapy), eating less and more meals, avoiding monosaccharide foods, and paying attention to the intake of coarse fiber foods, which can often eliminate the symptoms.