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Background <p>Reactive postprandial hypoglycemia, or dumping syndrome, is commonly associated with gastric surgeries or gastrostomy tube feeding but has not been previously reported in pediatric patients receiving nasogastric (NG) tube feeds.</p> Methods <p>We describe a 14-month-old girl with Trisomy 21 and congenital heart disease who experienced recurrent hypoglycemia while on NG tube feeds. Evaluation included continuous glucose monitoring (CGM), diagnostic fasting, and a mixed meal tolerance test.</p> Results <p>CGM revealed postprandial hyperglycemia followed by hypoglycemia. A mixed meal test confirmed inappropriate insulin secretion in the postprandial phase. Initiation of acarbose therapy led to immediate and sustained resolution of hypoglycemia without side effects.</p> Conclusion <p>This case highlights a previously unreported association between NG tube feeding and dumping syndrome in pediatric patients. It underscores the value of CGM in diagnosing complex causes of hypoglycemia and supports the effectiveness of acarbose in managing postprandial hyperinsulinemic hypoglycemia in the pediatric population.</p>

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Continuous glucose monitoring reveals severe and persistent postprandial reactive hypoglycemia in a nasogastric tube-fed infant

  • 期刊论文

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  • 发表日期：

    2026年1月7日

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  • Abdullah Almaghraby,
  • Seham Hamoud

摘要

Background

Reactive postprandial hypoglycemia, or dumping syndrome, is commonly associated with gastric surgeries or gastrostomy tube feeding but has not been previously reported in pediatric patients receiving nasogastric (NG) tube feeds.

Methods

We describe a 14-month-old girl with Trisomy 21 and congenital heart disease who experienced recurrent hypoglycemia while on NG tube feeds. Evaluation included continuous glucose monitoring (CGM), diagnostic fasting, and a mixed meal tolerance test.

Results

CGM revealed postprandial hyperglycemia followed by hypoglycemia. A mixed meal test confirmed inappropriate insulin secretion in the postprandial phase. Initiation of acarbose therapy led to immediate and sustained resolution of hypoglycemia without side effects.

Conclusion

This case highlights a previously unreported association between NG tube feeding and dumping syndrome in pediatric patients. It underscores the value of CGM in diagnosing complex causes of hypoglycemia and supports the effectiveness of acarbose in managing postprandial hyperinsulinemic hypoglycemia in the pediatric population.