I've just got a machine for measuring blood glucose levels.
I tried it out last evening, immediately after dumping, and it was 9.6. Half an hour later it was 3.1 I then had a sweet drink, and did feel a bit better. But how long should I have waited before I did the test?
Hi
blood glucose meters are very useful for monitoring but they need to be used in a systemised way.
You say that you used it "immeadiately after dumping". I need a little more information to understand this.
1. how long after eating did you do the test?
2. what had you eaten?
3. what "dumping" symptoms had you had when you did the test.
In general terms the best time to do the first test is approximately 1 hour after eating and then an hour after that. But this is the protocol for those who are diabetic or pre diabetic and of course we are slightly different 
The low blood sugar that you encountered is a sign of late dumping when the sugar spike has over stimulated insulin production.
Ideally you should take a little sugar when you start to get the feeling of light headedness that is indicative of this hypo glycemic state. Over time you will learn to sense the right moment.
Sometimes it is good to have something sweet about an hour after you've eaten just to top up your levels.
However it is very important to get a complete view of your diet and identify which foods are causing your dumping episodes.
If you suffer them frequently as I do I would recommend that you look into a low glycemic load diet as it is the initial sugar spikes that are caused by refined sugars and carbohydrates that are usually the root cause of the problem. Slow release foods will usually reduce although not eliminate completely these unpleasant symptoms.
Hope that helps a bit.
regards Larry
Hello Larry,
I had eaten a quorn bacon sandwich about an hour before, but then I had been slowly nibbling mince pies. I'm afraid I'd had three. So it's not surprising I dumped. I had been lying propped up on my bed, as I always do after a meal, and had taken the mince pies with me. I had my laptop on my tummy.
The symptoms I had were, first a sweaty hot feeling, then that unpleasant feeling inside that slowly turns to pain, and my heart banging, I did the first blood test at that point, then had to dash to the loo. I felt very dizzy by the time I got back to my bed, so I closed my eyes and slept for about half an hour, and did the second test when I woke.
I do tend to graze rather than eat a few big meals, and usually have a supply of food by my bed. for nibbling
Hot food makes me ill.
Thanks for your help.
I am afraid three mince pies are what probably set off the dumping. Stick to just one then if you fancy another wait for another hour to pass before trying your second mince pie. I love them too but learned quite quickly that they always cause an episode of dumping when i try to eat more than one together. Merry Xmas.
I had surgery 13 months ago. A merendino interposition. I've tried to evaluate the infrequency and severity of dumping attacks, and its difficult. Even my surgeon would not comment as "everybody is different".
The reason it is unpredictable is that things that give me a problem which is usually sugar related do not always. I can eat chocolate sometimes but not always.
What I have noticed for myself is that sweet things by themselves with an empty system do not give me a problem. But if I have something sweet after eating, I feel ill. So volume of food seems to be related. This would suggest that as there is some sugar in most foods the amount of sugar/glucose and perhaps just volume is relevant to the severity. Also, and maybe not everybody is the same, I always get dumping (occasionally) only in the late afternoon or evening. Never in the morning. So I can only assume it is volume related again. It could be that overnight your body has returned your system to normal.
I have found that after an 'attack', I feel wobbly, feel I need something and a cup of tea with sugar makes me feel better.
So I think my 'cause' is too much insulin as the result of too much food & sugar and LarryR has commented above that production of insulin can be a cause of an attack, which is the 'effect', and later you need a LITTLE sugar to get the balance back.
Keep monitoring your glucose level and learn. But as my surgeon says, everybody is different.
Personally, and this is only my opinion, dumping is caused by too much insulin as the result of more sugar than your 'new system' can handle. What I find worrying is that informed sources say that over stimulation and insulin dumping can lead to diabetes.
Hello Medway
Thanks for your help.
This is very confusing. I thought the dumping was caused by the volume of food being too much for my new small stomach, some spilling out, and the overspill caused the insulin spike. It's obviously much more complicated. I've got a lot to learn. What you've said makes a lot of sense.
I can usually eat sweet things within reason, it's fatty foods that are more of a problem.
Like you, late afternoon and evening is the worst time.
What you say about diabetes is worrying. I'm going to read and reread everything I can find on the subject of dumping, and hope to learn.
But the real difficulty is not having just one more mouthful of food I'm enjoying.
Hi
I agree that this is a very confusing subject. It is a true syndrome with a number of apparently unrelated symptoms and mechanisms working in combination.
So let me try and unravel it a bit.
The PROBLEM is undigested food entering the small intestine.
This can be accacerbated by a number of things.
Mechanical factors - connected with the reduced size of the stomach and removal of valves
1. eating too much
2. eating too fast
3. eating and drinking together
4 eating and moving around too soon
Bio mechanical factors - primarily the removal of the vagus nerve which is the main digestive control mechanism. It effectively determines the rate at whcih food is passed through our system. Anyone who has had an oesophagectomy will have lost the vagus nerve function as it runs through the oesophagus
So we are very prone to undigested food entering the small intestine which in turn triggers the unpleasant physical effects such as cramping and also induces the over production of insulin as the food will be seen by the gut as having high sugar concentrations. This is often accompanied by water flooding into the intestine, gurgling etc.
The physical discomfort often build up to episodes of diarrhea.
The insulin related issues are the feintness, palpitations, sweating etc. And it is learning at which point to take a little sugar to either avert or counteract these that takes some time to learn. I get it right more often than I used to BUT still encounter them.
As you acknowledged in this particular episode it was the 3 mince pies that are most likely the cause of the attack.
One of the reasons that I increasingly advise patients to adopt a low glycemic load diet is that there is a growing evidence that over time these repeated episodes of sugar spiking and hypo glycemia MAY induce a condition known as insulin resistance. This is what is many refer to as type 2 diabetes.
In my own case I have definitely found that my average levels have increased consistently over the last few years. I'm now trying to keep it under control with a strict low glycemic load diet.
Of course what I don't know is if I would have developed it anyway. So the jury is out over whether it is a long term side effect of the surgery.
If the condition persists I'd advise discussing it with your medical team, a specialist dietician and possibly a gastroenteroligist. I have found all 3 extremely helpful in getting my dumping syndrome under control.
I wish you well.
Larry
Thank you all for your help.
Just one more question, do you find it difficult, having to remember ALL the time that you're "not normal"? It's nearly three years since my op., and I still almost bend to pick something from the floor, and stop myself just in time, or lie down flatter than is safe, or eat one more mince pie, then think oops, shouldn't have eaten that.
I'm not moaning, I know how lucky I am to be alive, and to feel well enough to forget, but does it happen to you?
I think it happens to all of us.
It is hard and I know what you mean.
Unfortunately we have had a "cure" that doesn't fade with time.
We are reminded of the fact that we're different every time we eat and drink.
And you're right there are so many things to remember that it can get frustrating.
When it does all we can do is remember that there are many people who have far worse lives than we do!
Larry
Diabetes and oesophagectomy 
Swallowing difficulties 5 months post-op
From a Carer’s Perspective 
Bad dumping incident?
