Late Dumping-Hypoglycemia

Hello,

Please see the publication on this topic. Hope this helps.

 

0021-972X/06/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 91(11):4223–4231 Printed in U.S.A. Copyright © 2006 by The Endocrine Society doi: 10.1210/jc.2006-0557

REVIEW: Long-Term Impact of Bariatric Surgery on Body Weight, Comorbidities, and Nutritional Status

Meena Shah, Vinaya Simha, and Abhimanyu Garg

Division of Nutrition and Metabolic Diseases (M.S., V.S., A.G.), Department of Internal Medicine (V.S., A.G.), and Center for Human Nutrition (M.S., V.S., A.G.), University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75235-9052; and Department of Kinesiology (M.S.), Texas Christian University, Fort Worth, Texas 76129

 

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Macronutrient deficiency and intolerance

Protein deficiency, assessed by serum albumin levels, is less common than most other nutrient deficiencies (Table 2) (66–69). To consume enough protein, patients should be advised to consume fish, which is better tolerated than meat.

Simple sugar intake, especially added sugars (64), has been reported to cause dumping syndrome in as many as 76% (84) of the RYGB patients. The food rapidly enters the small intestine causing an osmotic load, which leads to movement of fluid from the blood into the intestine (85, 86). Rapid food entry into the jejunum also stimulates a substantial release of peptide hormones (85, 86). Clinical manifestations of the dumping syndrome include gastrointestinal symptoms such as early satiety, nausea, cramps, and explosive diarrhea and vasomotor symptoms such as sweating, flushing, palpita- tions, dizziness, and an intense desire to lie down (85). The insulin response is exaggerated and causes hypoglycemia (85, 86). To prevent dumping syndrome, patients should avoid consuming fruit juices and foods and drinks with added sugar (64); consume frequent, small, dry meals be- cause water can make the food more soluble; include dietary fiber; increase dietary protein (especially fish and chicken); and modestly increase dietary fat (to delay gastric emptying) (86).

Thank you very much for the information. I am beginning to accept this as something over which I have some control. I am now following all of the recommendations that are contained in this article. I have never experienced any 'early 'dumping, and I have not knowingly ingested any food or drinks with added sugar. since my surgery.  I think that is why I felt so blindsided by the term 'late dumping' and that translated into FEAR for me! Thanks again for the info!
Cindy

This is something I too experience, unfortunately. 

I was told not to eat candy, we don't need to get back into bad habits, instead, one of the best things you can do is drink some milk or eat some protein. It's good to always carry glucose with you, gel is best in case someone else needs to give it to you. If you do eat candy or drink juice it's very important to follow it with protein or your levels could spike up and then drop suddenly again.

It's also very important to check your blood sugars and not to let them get below 50 if you can help it, that's when the damage is being done. I carry a monitor with me as well as individual packs of jerky.

Like Diane said, split your meals, eat smaller portions every few hours.  Watch your carbs as well. This happens to some of us but it can be controlled.