What would cause hypoglycemia (60) with high beta hydroxybutyrate 3.2 and insulin high at 7.3? non fasted, non diabetic.

Reactive hypoglycemi: B"sd sounds like a colleague has ordered hypoglycemia evaluation. Clinical details needed for full interpretation, but the results given would be compatible with typical post-prandial reactive hypoglycemia. Often seen in states of insulin resistance which would include pre diabetes. More than happy to discuss with the details. High BH pretty much rules out insulinoma or insulin injection.