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dumping?/hypoglycemia

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Please help!

1.Can patients have dumping syndrome after consuming sugar alcohols?

2.If patient experience reactive hypoglycemia what sugar sources

should they consume?can they consume glucose tablets?

3. Can patients experience dumping after consuming fructose?

Thank you!

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sugar alcohols can cause great stomach upset and discomfort. Ranging from gas and bloating to severe diarrhea. This is not exlusive to the bariatric surgery population but may affect anybody who is sensitive.

Tina Musselman RD, CCN Bariatric Program Coordinator (708) 747-4000 ext. 7444 or 679-2717 (708) 679-2418 (fax) tina.musselman@...

From: [mailto: ] On Behalf Of Marina SavelyevaSent: Friday, January 18, 2008 12:50 PM Subject: dumping?/hypoglycemia

Please help!1.Can patients have dumping syndrome after consuming sugar alcohols?2.If patient experience reactive hypoglycemia what sugar sources should they consume?can they consume glucose tablets?3. Can patients experience dumping after consuming fructose?Thank you!

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I have been recently researching the issue of post-prandial hypoglycemia and glucose alterations in post op RNY patients. Hence, I am kind of green about the subject but here is something to be aware of...

What you describe may not necessarily be dumping but it may be related to an insulinoma or nesidioblastosis. Nesidioblastosis is characterized by pancreatic cell hypertrophy and hyperplasia and is treated by a partial pancreatectomy. Incidence of this condition in post op RNY patients is 400 times that of the general population. While scientists don't know the cause , there is discussion that this condition of hyperinsulinemic hypoglycemia results from rapid transit of food into the distal ileum which triggers an increase in GLP1. GLP1 increases insulin secretion and insulin sensitivity thus enhancing insulin mediated glucose disposal. The cause of the hypertrophy and hyperplasia is unknown but may be related to chronic increase in GLP1 or some other mechanism.

The botom line is that the patients symptoms may not be about reactive hypoglycemia or dumping syndrome but about something much more severe... Patient should get the following labs for evaluation: glucose level, insulin level, and c peptide (fasting).

If anybody knows about nesidioblastosis, I would love to hear about your experience in its diagnosis and management.

********************************************

Darcie Ellyne, MS, RD, CDE

Palo Alto Medical Foundation

795 El Camino Real

Palo Alto, CA 94301

********************************************

650.853.2961

-----Original Message-----From: [mailto: ] On Behalf Of Marina SavelyevaSent: Friday, January 18, 2008 10:50 AM Subject: dumping?/hypoglycemia

Please help!1.Can patients have dumping syndrome after consuming sugar alcohols?2.If patient experience reactive hypoglycemia what sugar sources should they consume?can they consume glucose tablets?3. Can patients experience dumping after consuming fructose?Thank you!

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