Post prandial idiopathic hypoglycaemia and Rapid Gastric Emptying

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Sedbet

Sedbet

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Hi everyone, I am a new member who is not diabetic but have been diagnosed with the above - the hypoglycaemia was diagnosed in 2010 and the Rapid Gastric Emptying (Dumping Syndrome) was diagnosed in 2012. Since then I have been put on Morphine 3 x daily, Acabose, Metformin and 400 injections of Octreotide (15 minutes before each meal). None of these achieved the desired effect of slowing down of my food. I have now been told by my hospital that there is nothing more that can be done and that I have to learn to live my life around my symptoms!

I am a keen golfer and really struggle with energy, shaking muscles etc and I wonder if anyone can suggest a pre golf meal and food to take out on the course with me (usually about 4 hours to play a round).
 
Maybe you need a liver function test via blood test as "liver dump" rather than rapid gastric emptying sounds more accurate. Liver dump is where vast glucose amounts are released into the blood stream, and can be due to poor liver function. It happens usually in the morning, yet after eating food maybe also. The liver is sensitive to insulin and responds according to the type of insulin hormone, and dependent upon the level of quality the liver is functioning at, it may respond differently due to diet/type of insulin produced by pancreas due to type of carbohydrate intake -
 
Oops hang on... Overall liver function variations (elevated vs normal vs decline of liver enzyme production - and also type of enzyme - according to state of liver) has links to insulin response and liver dump of glucose into blood and rest of body.
 
Hello Sedbet and welcome to the forum. Just to clarify, as I understand it, Gastric dumping, and 'liver dumping' ( when the liver releases too much glucose) are two entirely separate things, and it's Gastric dumping that you've got to contend with. I think I've just read on another post that this is something that @eggyg suffers with, so she might have some insights on it.
 
Pamela Giddings said:
Oops hang on... Overall liver function variations (elevated vs normal vs decline of liver enzyme production - and also type of enzyme - according to state of liver) has links to insulin response and liver dump of glucose into blood and rest of body.
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Or it could be pancreatic function releasing too many enzymes into stomach causing rapid digestion and release of glucose. I recommend both blood tests for pancreas and liver function.
 
Welcome Sedbet 🙂. You have got your hands full. Golf is good exercise. If it where me I would have Porridge because it lasts for hours but I am not an expert on your probs. Really good luck & keep at the Golf 😎
 
Robin said:
Hello Sedbet and welcome to the forum. Just to clarify, as I understand it, Gastric dumping, and 'liver dumping' ( when the liver releases too much glucose) are two entirely separate things, and it's Gastric dumping that you've got to contend with. I think I've just read on another post that this is something that @eggyg suffers with, so she might have some insights on it.
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Thank you Robin. Yes, I was given a radioactive meal and filmed for 90 minutes while the meal made its way through. At the end I was diagnosed with rapid GASTRIC emptying. I will visit eggy's page and see if she can help.
 
Thank you Martin, I will follow up your link.
 
Hi @Sedbet. I do have gastric dumping syndrome. I was led to believe mine is caused by all the surgery I have had, removal of most of pancreas, spleen and gall bladder. Apparently it’s also quite common if you have had a gastric bypass. It’s a bleeding nuisance at times. I really wish I had answers for you but this is what works for me ( sometimes), small meals, not too many carbs, especially simple carbs, pastry, sweets, cakes. Alcohol does affect me sometimes if taken with a large meal. I often pass out if I can’t get to lie down. Have had some very embarrassing situations in restaurants and hotels! Hope this helps a wee bit. Good luck. Elaine.
 
Pamela Giddings said:
Oops hang on... Overall liver function variations (elevated vs normal vs decline of liver enzyme production - and also type of enzyme - according to state of liver) has links to insulin response and liver dump of glucose into blood and rest of body.
Click to expand...
Hello Pamela, Thanks for your messages. I have had both liver and kidney function tests which both came back normal. I appreciate your help, thank you again.
 
eggyg said:
Hi @Sedbet. I do have gastric dumping syndrome. I was led to believe mine is caused by all the surgery I have had, removal of most of pancreas, spleen and gall bladder. Apparently it’s also quite common if you have had a gastric bypass. It’s a bleeding nuisance at times. I really wish I had answers for you but this is what works for me ( sometimes), small meals, not too many carbs, especially simple carbs, pastry, sweets, cakes. Alcohol does affect me sometimes if taken with a large meal. I often pass out if I can’t get to lie down. Have had some very embarrassing situations in restaurants and hotels! Hope this helps a wee bit. Good luck. Elaine.
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Gosh Eggyg, you have had a lot of problems. I have never had any stomach or digestive surgery and because of this none of the medical people I have seen seem to know what to suggest. I appreciate your suggestions. I have been having smaller meals but I haven't been restricting my carbs enough so I will try this. Now I am starting to understand RH more, after joining this site, I am realizing just how important carb control is. Thank you again for your advice.
 
HOBIE said:
Welcome Sedbet 🙂. You have got your hands full. Golf is good exercise. If it where me I would have Porridge because it lasts for hours but I am not an expert on your probs. Really good luck & keep at the Golf 😎
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Thank you for your kind welcome. I played golf on Friday and had rolled oats porridge and skimmed milk for breakfast and took oat cakes with peanut butter with me. By the time I got to the 3rd hole my muscles were shaking so much I had to ride on someone's buggy so I think porridge may be a no no for me. I appreciate your advice though.
 
Sedbet said:
Thank you for your kind welcome. I played golf on Friday and had rolled oats porridge and skimmed milk for breakfast and took oat cakes with peanut butter with me. By the time I got to the 3rd hole my muscles were shaking so much I had to ride on someone's buggy so I think porridge may be a no no for me. I appreciate your advice though.
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Hi Sedbet I am not a Dr but I would think about hydration ? How much liquid had you had. Porridge is a slow release of carbs.
 
HOBIE said:
Hi Sedbet I am not a Dr but I would think about hydration ? How much liquid had you had. Porridge is a slow release of carbs.
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Hello Hobie, Re: Hydration.
I usually drink about 2 pints during the night and had had about another pint before I left to play golf - my tee off time was at 10.45am. My muscle shakes started about 30 minutes after I started playing by which time I had only drunk about another 1/2 pint.
 
There's me thinking you where walking about for a couple of hours in this warm weather. Muscles shacking ? Good luck Sedbet .
 
Hello Sedbet, and welcome 🙂

My partner has hypoglycaemia, though I'm not sure if it's the same type as yours. He finds it helps to eat little and often, and not to have too many carbs in any one meal. It also helps to eat a snack last thing at night - a yogurt is ideal - so he doesn't wake up starving.

I think it's a while now since he's had the shakes really badly, but he used to get them quite often. He carries fruit around with him, because when he's hypoglycaemic he needs fast-acting carbs (just the same as someone on insulin would when we hypo). Dried fruit is the best for dealing with bad shakes, it acts very quickly - so perhaps you could carry some raisins or dried apricots round with you and see if they help. A banana might be another option. Slow-acting carbs won't have the same effect, and I'd have thought oat cakes with peanut butter would be too slow (and the fat in the peanut butter will slow down the effect of the carbs in the oat cakes).

It feels very strange giving this advice on diabetes forum as normally I'd be advising people to steer clear of dried fruit and bananas! Just don't overdo it ...
 
TheClockworkDodo said:
Hello Sedbet, and welcome 🙂

My partner has hypoglycaemia, though I'm not sure if it's the same type as yours. He finds it helps to eat little and often, and not to have too many carbs in any one meal. It also helps to eat a snack last thing at night - a yogurt is ideal - so he doesn't wake up starving.

I think it's a while now since he's had the shakes really badly, but he used to get them quite often. He carries fruit around with him, because when he's hypoglycaemic he needs fast-acting carbs (just the same as someone on insulin would when we hypo). Dried fruit is the best for dealing with bad shakes, it acts very quickly - so perhaps you could carry some raisins or dried apricots round with you and see if they help. A banana might be another option. Slow-acting carbs won't have the same effect, and I'd have thought oat cakes with peanut butter would be too slow (and the fat in the peanut butter will slow down the effect of the carbs in the oat cakes).

It feels very strange giving this advice on diabetes forum as normally I'd be advising people to steer clear of dried fruit and bananas! Just don't overdo it ...
Click to expand...
 
Hello Juliet,
Thank you so much for your advice which I have already started following. I hope you don't mind this long reply but you seem to understand my problems.

I played golf today (much better!). For breakfast I had 2 soft boiled eggs, 1 small slice of Bergen buttered bread and a cup of boiled water (that is all I drink normally). On the golf course I had a 'smoothie type drink' made with single cream, natural yogurt, little skimmed milk (to thin it down) and a few blueberries, also cold water to drink. I seemed to cope well with this. When this ran out I had 1 round of Bergen bread, small slices, with butter and peanut butter on, this was cut into 1/4s which I nibbled very slowly over several holes of golf. During this time I started shaking on 3 separate occasions - each time I had 1 glucose tablet and then followed it with part of my sandwich. Not too successful.

Shortly after finishing golf I had blurred vision (still got it 4 hours later), also 'warm' pins/needles/numbness in my left thigh and a feeling of my thigh muscles seizing up in both legs - this is not uncommon.

In 2010 I had a glucose tolerance test and then BS checked frequently. 2 hours 45 mins later I got extremely shaky, blurred vision etc and my reading was 2.1. This test was done in hospital and I was told I was hypoglycaemic and since then I have been referred to 11 different dieticians all with differing advice. I have followed all advice meticulously but to no avail! You will see from my Profile page that I have also been put on morphine 3 times a day then Acarbose, Metformin and almost 400 stomach injections with Octreotide that I did myself 15 minutes prior to every meal. I have now been told that there is nothing more that can be done and I will have to live my life around my symptoms.

Are there any other tests for hypoglycaemia that I could ask my Doctor for?

I would really appreciate your comments. Jen x
 
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