Patient reviewing results with his doctor

Specialized Care & Treatment

The Hypoglycemia Clinic at Joslin provides patients with an evaluation and personalized management of complex hypoglycemia syndromes in adults. After a comprehensive analysis and evaluation of our patients documented hypoglycemia for both diagnostic and treatment needs.Together, our staff will help you prevent this condition by identifying its underlying cause and then recommending treatment. Sometimes patients need new medications or to adjust their current dosage. Other times, they need surgical treatment. 

Hypoglycemia is a condition that involves very low blood sugar levels. The team at Joslin recognizes that hypoglycemia can difficult to live with, disabling, and even life threatening. There are many causes of hypoglycemia, even in patients without diabetes including medications and supplements or medical and hormonal conditions. Hypoglycemia can also follow a gastrointestinal surgery, a post-bariatric hypoglycemia occurring after gastric bypass or sleeve gastrectomy. Other forms of hypoglycemia include reactive hypoglycemia or postprandial hypoglycemia. 

All of our patients have access to leading edge research in the treatment of hypoglycemia, including the latest clinical trials.

Mary-Elizabeth Patti MD FACP
Investigator and Adult Endocrinologist

    Meet Our Specialists

    Our team includes an adult care endocrinologist with expertise in clinical care and research studies of hypoglycemia, a nurse practitioner with expertise in evaluation and treatment of post-surgical hypoglycemia and a registered dietitian and a certified diabetes educator with expertise in helping patients with hypoglycemia.

    Mary-Elizabeth Patti
    Mary-Elizabeth Patti, MD
    Staff Physician
    Director, Hypoglycemia Clinic
    Co-Director, Molecular Phenotyping Core
    Associate Professor of Medicine, Harvard Medical School
    Nicole Patience
    Nicole Patience, MS, RDN, LDN,CDE, CEDRD
    Nutrition Educator
    Eating Disorder Specialist


    Research publications on post-bariatric hypoglycemia by the staff of the hypoglycemia clinic.

    • Review article  "Hypoglycemia after Gastric Bypass Surgery" published in the August 2018 issue of Journal of Clinical Endocrinology and Metabolism (written primarily for endocrinologists).  [PDF]
    • Commentary by Dr. Patti summarizing post-bariatric hypoglycemia, a condition increasingly recognized in patients who have had bariatric and other forms of upper gastrointestinal surgery.  [PDF]
    • Handout from 2018 Meet the Professor Session at ENDO2018 about post-bariatric hypoglycemia (written for endocrinologists)  [PDF]
    • Our expert dietitian, Emmy Suhl RD, MS, summarizes the critical nutritional approaches to managing this condition. [PDF]
    • Article from our hypoglycemia team which  describes first steps to developing a glucagon delivery system to prevent hypoglycemia in this setting, information now guiding current ongoing research  [PDF]
    • Handout for physicians and other clinicians who may be seeing patients in an urgent care or emergency setting, describing strategies for managing acute aspects of hypoglycemia [PDF]