Overview.
Postprandial hypoglycemia is also known as delayed postprandial dumping syndrome. It refers to a series of hypoglycemia that occurs when gastric emptying is too fast after gastrectomy and glucose is rapidly absorbed by the intestinal mucosa, resulting in a sudden increase in blood glucose, which stimulates the pancreatic islets to secrete too much insulin.
Etiology
Dumping syndrome refers to a series of hypoglycemia that occurs when the pylorus or its normal function is lost after gastrectomy and gastrojejunostomy due to surgery, in which the food in the stomach is suddenly dumped into the duodenum or jejunum, and glucose is rapidly absorbed by the intestinal mucosa, resulting in a sudden increase of blood glucose, which stimulates the pancreatic islets to secrete too much insulin.
Symptoms
The onset of hypoglycemia often occurs 90 to 180 minutes after eating a meal (especially eating a large amount of carbohydrates), and is characterized by extreme weakness, powerlessness, dizziness, panic, trembling, cold sweat, and in severe cases, impaired consciousness. There are no obvious positive signs on examination. Plasma insulin is often 3-4 times higher than normal before the attack, and blood glucose is significantly lower during the attack. In a few cases, there may be dumping syndrome first, followed by postprandial hypoglycemia.
Examination
Blood glucose test.
Diagnosis
The onset of the attack often occurs 90 to 180 minutes after eating a meal (especially eating a large amount of carbohydrates) and is characterized by extreme weakness, weakness, dizziness, panic, trembling, cold sweat, and in severe cases, impaired consciousness. There are no obvious positive signs on examination. Plasma insulin is often 3-4 times higher than normal before the attack, and blood glucose is significantly lower during the attack. In a few cases, dumping syndrome may be present first, followed by postprandial hypoglycemia.
Treatment
Patients are usually treated on an outpatient basis. Eat small, frequent meals, reducing starchy foods and increasing proteins and fats. Symptoms can be relieved with sugar water during an attack. A severe hypoglycemic reaction can be treated with 40 ml of 50% dextrose by sedation.