postprandial hypoglycemia
Introduction
Introduction to postprandial hypoglycemia Also known as postprandial late-type dumping syndrome, refers to gastric emptying after gastrectomy, glucose is quickly absorbed by the intestinal mucosa, resulting in a sudden increase in blood sugar, stimulated a series of hypoglycemia caused by excessive islet secretion of insulin. basic knowledge The proportion of illness: 0.003%-0.008% Susceptible people: no specific population Mode of infection: non-infectious Complications: disturbance of consciousness
Cause
Causes of postprandial hypoglycemia
Dumping syndrome refers to the loss of pylorus or its normal function after gastrectomy and gastrojejunostomy due to surgery. The food in the stomach suddenly dumps into the duodenum or jejunum. Glucose is rapidly absorbed by the intestinal mucosa, causing a sudden increase in blood sugar. A series of hypoglycemia that occurs when the islets secrete too much insulin.
Prevention
Postprandial hypoglycemia prevention
After gastric resection or gastrointestinal anastomosis, patients should eat less meals, eat more dry food, less soup, limit carbohydrates, especially sugar, should eat high protein, high fat and low carbohydrate diet, need to lie after eating About half an hour. Develop the habit of drinking water during meals or on an empty stomach. Take anticholinergic drugs (such as atropine, belladonna or prufenone) 20 to 30 minutes before meals to prevent excessive gastrointestinal motility. Oral administration of metobutamide It can shorten the duration of hyperglycemia.
Complication
Postprandial hypoglycemia complications Complications
A disturbance of consciousness can occur severely. The occurrence of symptoms is not only related to the degree of blood sugar drop, but also related to the speed of blood glucose decline, the duration of time and the patient's body reactivity. Clinically, early morning breakfast or lunch, before dinner, due to hunger, fatigue, mental stimulation, drinking, fever, etc. can induce hypoglycemia, the duration of the attack varies, the shortest is only 3 to 5 minutes. Most of the early symptoms are mainly sympathetic excitation, such as spontaneous sweating, fatigue, nervousness, rapid heartbeat, pale complexion, nausea, vomiting, and tremor of the extremities. The heavier ones are hypoglycemia and hypoxia, conscious and paralyzed. , convulsions, stupor embolism, long-term illness, often affect intelligence, memory, orientation.
Symptom
Postprandial hypoglycemia symptoms Common symptoms Postprandial hypoglycemia, dizziness, flustered, cold, sweat, trembling, consciousness disorder, dumping syndrome
Often eating 90-180 minutes (especially eating a lot of carbohydrates), after the onset, manifested as extremely weak, weak, dizziness, palpitation, trembling, cold sweat, severe cases can occur disturbance of consciousness, no significant positive signs of physical examination, before the attack Plasma insulin is often 3-4 times higher than normal people, and blood sugar is significantly reduced at the time of onset. In a few cases, there may be a dumping syndrome, followed by postprandial hypoglycemia.
Examine
Postprandial hypoglycemia check
Blood glucose test
1. Implementing blood glucose monitoring can better control your own blood sugar changes, and has important guiding significance for life rules, activities, exercise, diet and rational use of drugs, and can help patients find problems at any time and go to the hospital in time.
2. The results of blood glucose monitoring can be used to reflect the results of diet control, exercise therapy and medication, and to guide the adjustment of treatment options to improve treatment.
3. Real-time blood glucose testing can reduce the risk of diabetic complications.
4. Good glycemic control can improve the quality of life of patients and improve their physical condition.
Diagnosis
Diagnosis and identification of postprandial hypoglycemia
Often eaten for 90-180 minutes (especially eating a lot of carbohydrates), after the onset, the performance is extremely weak, weak, dizziness, palpitation, trembling, cold sweat, severe cases can occur disturbance of consciousness. There were no obvious positive signs in the examination. Before the onset, plasma insulin is often 3-4 times higher than that of normal people, and blood sugar is significantly reduced at the time of onset. In a few cases, there may be a dumping syndrome, followed by postprandial hypoglycemia.
Differential diagnosis
1. Extra-pancreatic tumors.
2. Functional hypoglycemia.
3. Chronic adrenal insufficiency (Addison disease).
4. Lychee disease.
5. Drug-induced hypoglycemia.
6. Glucose utilization or loss of excess.
7. Insufficient food intake.
