Baricol / News Archive / Late Dumping aka Reactive Hypoglycaemia after WLS
Woman with long hair and hands over her heart with late dumping

Late Dumping aka Reactive Hypoglycaemia after WLS

A lot of people have experienced the phenomenon of dumping after surgery.   You’ve eaten something with a little too much fat or sugar, or perhaps you ate just a little too fast.  And then it hits. Dizziness. Flushing. Cold sweats.  Rapid heartbeat.  Feeling like you’re going to faint.  Most of the time you can trace this back to what you’ve just eaten and figure out what the culprit was.  This is what we call “early dumping.”  About 10-30 minutes after eating, early dumping occurs when food enters your intestine more quickly than normal. A rush of fluids from the bloodstream then follows making you feel sick.  But what about when you have these types of symptoms when you haven’t eaten in a while? You may be experiencing late dumping aka reactive hypoglycaemia.

Late Dumping

If you are experiencing tiredness, sweating, fatigue, etc,  1-3 hours after a meal, you’re probably going through “late dumping.” Late dumping is similar to early dumping in that certain foods bring it on, specifically those high in carbohydrates. Where it differs is that the symptoms are brought on by hypoglycemia, or low blood sugar. You might be asking yourself, “Why would I get hypoglycemia after eating a lot of carbohydrates?” After a high-carb meal that spikes your blood sugars, your body can sometimes overestimate the amount of insulin you need, which causes your blood sugars to drop below typical levels.  This is also called “reactive hypoglycaemia.”

What to do if you suffer from late dumping?

For a quick remedy to reactive hypoglycemia, have something that will raise your blood sugars quickly without causing another round of early or late dumping.   I typically suggest having foods with carbs and protein and/or fat.   Yogurt, milk, fruit, nuts or nut butter, crackers with a little cheese, etc.  You could also take glucose tablets, hard candy, juice, or something else that will shoot up your blood sugars quickly, but the risk is that if you take too much, you could provoke early or late dumping again.  But these are only in-the-moment solutions.  The best way to deal with late dumping is to prevent it.

Think about how you eat:

  • Have your portions of carbohydrate-dense foods gotten bigger?
  • Are you including protein every time you eat?
  • Are you skipping meals?
  • Can you choose carbohydrates that digest more slowly?
  • Could you add a little fat to your meal?

If the answer to why you’re experiencing late dumping does not feel clear, contact a bariatric dietitian at your clinic for help.

What if the diet alone does not improve my hypoglycaemia?

There are cases when, despite dietary interventions and help from the dietitian, reactive hypoglycaemia just keeps on happening. In these cases,  there’s an option to combine medication with dietary changes. Your provider would likely prescribe a medication called acarbose which delays the absorption of carbohydrates from the intestine. If this does not work, treatment with a medication called a  GLP-1 analog is next. GLP-1 helps to balance the amount of insulin your pancreas puts out with the amount of glucose in your blood.

When dizziness and discomfort may be caused by other things

There are many reasons you might feel a little dizzy after surgery.  A lot of people experience low blood pressure as they are losing weight and need to have their medications adjusted if they are taking any. You also might need to be careful about how quickly you change positions: sitting to standing, laying down to sitting up, etc, to help prevent lightheadedness at times.  Sometimes people need to add extra salt to their food to keep their blood pressure from dropping too low!

Another reason for dizziness or unease could be vitamin and mineral deficiencies. Low vitamin B12 and low iron can both bring on symptoms similar to those associated with low blood sugars. Remember to check your blood work at least once a year, and make sure to take your vitamins!

Keep your blood work in check with us!

Baricol® Complete is made specifically for people who have had bariatric surgery and contains all of the necessary vitamins and minerals in 1 simple product.   Choose from our unflavored Powder, Chewable, Effervescent, or Tablets. Baricol® Complete is recommended by healthcare professionals and replaces the standard prescription recommendation of iron, calcium, vitamins D and B12,  and a women’s multivitamin.

Read more about life after WLS in our other blog posts!