Hypoglycemia after gastric surgery? Let’s consider dumping syndrome

Abstract

Introduction
Dumping syndrome can cause hypoketotic hypoglycemia. It is more common in patients with a history      of gastric surgery, particularly following Nissen fundoplication. We must consider this entity and perform glycemic monitoring in patients with surgical backgrounds.

This article discusses two cases of dumping syndrome. In both cases, the patients underwent Nissen fundoplication surgery, and after measuring glucose levels, postprandial hyperglycemia followed by hypoglycemia was observed, leading to a diagnosis of dumping syndrome.

In both cases, a dietary guideline was established, with more frequent and smaller feedings, avoiding rapidly absorbed carbohydrates. In addition, corn starch was added to the meals as a source of slowly absorbed carbohydrates, achieving good glycemic control.

Conclusions
In patients with a history      of gastric surgery presenting hypoketotic hypoglycemia, we must consider dumping syndrome. Nutritional management plays a key role and is often enough for symptom control. In this group of patients, postprandial glycemic monitoring should be considered.