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I have to be pretty careful what I do eat before not-eating for a while/fasting. Anything that spikes my insulin response (that can include too much protein or something with hidden sugar like carby bread) and I'm guaranteed reactive hypoglycaemia three hours later. I hate it! But if I'm good, I'm fine. I'm doing 18:6 fasting no probs if I make sensible choices and I'm so attune to hypos I can sense when they are coming pretty early on and then I pop a glucose tablet or take a teaspoon of maple syrup. I've got it down to a fine art because I HATE hypos (T2 diabetic in remission here).

Okay so this is getting really annoying. I have posted 3 blogs that have disappeared. =( Anyway, I have had a rough last couple of weeks. My grandmother is really ill and was in the hospital for a few days. Her liver is screwin up big time. I have gotten her into a different doctor because the one she was seeing is a quack and shouldn’t have a license. I am the only one close that can take care of her. And I’m pretty sure she is ready to give up. But I don’t want her to yet. She has to see my babies, if that ever happens, and see me finish RN school. DH was also sick. He has chemical pneumonitis and Reactive Airway Disease. He couldn’t breathe and went to the ER. They wanted to admit him but he refused and took an AMA. So they gave him breathing treatments, that we couldn’t afford, and steroids. So other than that drama. I have lost a couple more pounds. I talked to my doc, who was on my floor seeing another patient, and he said that 1 pound a week is plenty of weight loss. So that made me think about how much weight I have been losing. I started counting my calories on a website and I am sooooo not taking in enough calories. We are supposed to take in like 1200-1800 right? I am not even sure but its hard to reach that with how little I am able to eat. I know that my diet says that I am supposed to eat 3 times a day and nothing in between meals but that’s just not possible. I am eating very small snacks every couple of hours. That has helped me up my calorie intake quite a bit. I am down 2 more pounds which I am very happy with. In a couple more weeks I can go in for a fill if I need one. I think I am doing pretty well without one, lol. But anyway I have to go to class now. Its not for another hour and a half but the roads are icy and people don’t know how to drive and parking is DREADFUL at my school.

I am more than 14 months post-op. I do not dump, which happens to approx. 30% of gastric bypass (RNY or MGB) patients typically after consuming sugar. Nor do I experience Reactive Hypoglycemia (RH), which may show up 1+ years after gastric bypass; it is low blood sugar occurring 1-3 hours following a meal. Eating too fast or not chewing food properly and then getting the foamies and/or needing to vomit is not the same thing as dumping (aka rapid gastric emptying). Make sure you’re eating small, moist portions of protein and to eat slowly, and then these incidents should abate. Good luck.

Was hypo now hyper. Still on 800 calories a day Going to specialist today to get more info

I found out I was hypo in 1976 and have been on thyroid medicine since. Before banding, the weight was so hard to lose. I was banded 09022010 and have lost 24 pounds, which doesn't seem like a lot to me but hey at least I am losing and that is the main goal here. I just had my 2nd fill so hopefully it will go faster but because I do have a thyroid problem if I plateau or it is just slow I don't sweat it. But by all means take your medicine, because it not only messes with your weight but with so many other parts of the body especially the nerve center. Losing weight is already a depressing process but if you are on thyroid medication and don't take it you will get depressed and it will make matters worse. Take it from an old pro. LOL

We had a free health screening at work so I figured id see what my numbers were looking like almost 4 months post op. My cholesterol was down from a little over 200 a year ago to 109 now which is great and my blood pressure was perfect but my glucose levels were low. It was only 57 which seemed to concern the person taking it. I ate a banana about an hour before. Anyone know if this is a normal glucose level for an RNY patient? Or could it be reactive hypoglycemia from the banana?

I could have sworn I saw a post this morning about post-sleeve diabetes management. When I got to my office to post something, it was gone. So, I thought I'd start a thread - would love to hear from other diabetics in the group. Before my sleeve surgery, I was on 1.8 mcg of victoza, 2000 mg of metformin, 60 units of lantus and 60+ (sliding scale) of apidra daily. My surgeon reduced my meds immediately after surgery - no victoza, half the metformin and 10 units of each of the insulins. Unfortunately my blood sugars, particularly my fasting sugars, were not where I wanted them after I began solid food, so I consulted with my GP and we went back to 2000 mg of metformin (less chance of hypo), 25 units of lantus and 5-10 units of apidra. That's just freaking amazing. We also developed a plan to begin backing me off the medicines as the blood sugars come down. Both my surgeon and GP agree that if all continues to go well, I should be off the meds in a few months. I'm limiting myself to around 30 grams of carbs a day (my surgeon's plan allows for 60) and getting daily exercise. So, how's everyone else doing? Anyone off meds altogether? CJ

I am also hypo - I keep taking my syntroid

I relied so heavily on this forum and others in the months leading up to my procedure that I promised myself I would provide a 12 month update, FAQ and experience summary for others planning the same thing for the same reasons. I recently posted this to Reddit and bariatricpal rounds out the plan. My story is positive – overwhelmingly positive – but I think most importantly my story is not emotional. I don’t have a psychological problem with food. I was never tormented or made to suffer for my weight (beyond finding flights uncomfortable and shirts being too short). I made this choice on statistical grounds – it would extend my life on average and go a long way to improving my diabetes. I wanted to provide a vanilla story to remind everyone this pretty survivable and the majority of people have non-descript and unexciting recoveries. My lift is pretty much the same - I just eat a lot less, dont shoot insulin and hopefully will live longer. Forums tend to have an over representation of negative outcomes - that makes perfect sense and it's absolutely fine for people to use them to get some reassurance and communicate with people in the same situation. For everyone else - just remember you're less likely to jump on a forum and tell your story if nothing went wrong or it wasn't any different from other people and as a result it can seem like a higher proportion of people are suffering than maybe is the case. I was a lower-BMI diabetic, not quite type 1 or type 2, but insulin dependent nonetheless. My BMI was 31, my surgeryweight was 126kg (277lbs) and I’m 196cm tall (6’5). I was diagnosed at 100kg (220lbs) but assumed type 1 as I wasn’t visually overweight. However in the 5 years since diagnosis I’ve continued to produce some insulin suggesting I’m not a pure type 1 or 2 - but closer to type 2. I gained 26kg in a year after diagnosis once i started on insulin. I’m broad shouldered/chesty with skinny legs - like an apple jammed on some chopsticks. Maybe like the fat Mr Incredible. My intention for having the bypass was not solely weight loss – I suspected that my diabetes was closer to type 2. I suspected the improvements people see immediately in diabetes management post bypass may apply to me. It was a gamble that paid off, My decision making process was quite straight forward – I had a young daughter at the time (now have a son too) and had lost my father to a heart attack when I was 7. He was fit and not diabetic but had a heart condition. I new statistically I was due for a similar fate carrying excess weight plus diabetes onboard. This was the best way to knock out one of those (the weight side) and hopefully improve the diabetes. I went from 126kg to 83kg (180lb), my BMI is low end of healthy. My biggest positive is my immediate cessation of insulin shots and a current HBA1c of 5.8 with oral meds only. It took about 6 months to get to my goal weight of 90kg. I'm still slowly losing and need to stop. Lead-up and Prep I was not obese to look at visually. The majority of healthcare professionals I spoke to did not think surgery, let alone Gastric Bypass, was necessary. In the end – my PCP, endo and surgeon all agreed that, while not essential, bypass was a prudent decision with potentially long-term benefits. The surgeon did not want me to bother with a gastric sleeve – if the endgame was diabetes improvement then the gold standard was a bypass. In Australia you need to be over 35 BMI or over 30 with a comorbidity to be eligible. I had slightly elevated Blood Pressure - that plus the diabetes made me eligible. I paid $2000 out of pocket, my private health insurance paid the rest. No psych required, I had a few meetings with a nutritionist and everything was greenlit. From first enquiry to surgery was four months. The fee I paid includes lifetime consults with the surgeon. I did not need a pre-op diet as i was not that overweight and my liver was not a concern. Surgery My procedure was in June 2018. My anaesthetic recovery was rough, but otherwise the process was fine. The most discomfort was immediately in the 12 hours following – in part due to surgical site pain but mostly because the bed could not accommodate my height so I was forever crossing my legs or scrunching them up, only to have a nurse slap them and wake me up for fear of DVT. Nurses kept promising to find a bed extender - eventually I lashed out in a post-anaesthetic haze at a nurse who slapped my feet - she took the end off the bed with a flourish. My feet shot out, I cried in relief, apologised profusely and slept for eight hours. Day two was stiff and sore but i was mobile, able to shower and sipping fine. I went home the morning of day three. I had PHENOMENAL life ruining headaches from day two. I went home with some serious opiates because I lived 90 minuts from my surgeon and couldn’t drive to get a script if they hit again. On day four my dietician cleared me for coffee and it immediately wiped out the headache – turns out I’d been in caffeine withdrawal. So I really recommend you taper that off in advance if you have a problem with coffee like i do. If you're diabetic then buy a freestyle libre glucose monitor for the procedure if you dont have a CGM. They want hourly blood glucoses, instead of being woken and pin pricked every hour I could just show them how to use the scanner and they'd take it while i slept. I had some minor aches 6 weeks out and one of the surgery sites oozed a little clear fluid. It subsided immediately. I was home for two weeks. I could have gone back at one week. I'm an accountant though and my starting weight was comparatively low so i was mobile quick. I completely understand if you're starting form a heavier weight then you should plan to take the full time. Food/Eating The normal progression of foods was fine and unremarkable from what is described on most forms. I graduated to solids a little earlier than I should have. I cheated like mad and was feeling fine, it was only when I snuck a tiny piece of casserole beef and vomited violently did I start to behave myself. I was vomiting once or twice a week from eating too much or too fast. Savoury ricotta bake, hearty soups and coconut water were my saviors. The vomiting subsided, 18 months out I vomit maybe once every two or three months and only when I do something stupid. My problem before surgery was eating very fast and taking large bites – that has been hard to deal with post surgery. In fact I tend to still eat large bites and then sit unable to eat for extended periods. I was very sensitive to sugar post-op and frequently had dumping. That subsided in a month with changes in eating, changes in my appetite and better food/liquid rules. I currently only get dumping in the morning, and only if I eat something sugary. I do get nauseous easily in the morning too – it’s something I’m working with my nutritionist on to find out why. Otherwise I can eat whatever I want within reason. I don’t drink soda, but had quit it before my procedure. Milky protein makes me nauseous too (any type of creamy protein really) so I use a water protein additive from costpricesupplements. This helps me hit 2L fluids daily. I can eat about a cup and a half food. Liquidy foods – stews, soups, casseroles – I can eat a lot more than that. Tougher foods like steak or dry chicken much less. I gulp liquids. I had a sensitive stomach before the surgery and took Metamucil religiously to keep my gut regular. I have not had any issues post op with flatulence but have had looser bowels. Metamucil still helps – but no worse or in any way less manageable than pre-op. Diabetes I went off insulin immediately after my surgery. It wasn’t a cure – I’m still diabetic – but metformin and trajenta keep me in an aggressively managed hba1c. I have a so-so diet – I eat too much sugary junk food and carbs. I could go without diabetic meds I believe but my diet would be depressing so ive truck a compromise. On this basis alone this was the best decision I could have made for my physical wellbeing. My blood pressure is fine, my cholesterol is non-existent and I'm able to even job a moderate distance without discomfort. Random observations • I’m cold. So cold. It’s 35 degree outside where I am (90’s Fahrenheit) but as soon as I go into any office I need a sweater. I really became dependant on sweaters, long johns and socks this last winter. Im not cooler in summer – just as hot and bothered as before. Maybe a better way to describe it is that I feel the temperature more in general, like I lost my insulation. • I am too skinny. Clothes don’t fit that great – most men this tall have a bit more chest/gut on them. Australia has limited/no tall clothing ranges domestically so I’m importing loads of stuff from the UK/USA. i still think i look fat when i look in the mirror. • My bum is bony and I need cushions to sit comfortably. I also had a cyst on a butt cheek I didn’t know about – now im so bony there I’ll need to get it removed so I can sit on kitchen chairs comfortably again. • I gained about 1.5” of penis length. It was a welcome addition. I needed to learn how to be more gentle and patient using it. With a young family and little sleep it's yet to be fully road tested – but I’ll be ready when we start to sleep again. • I have a little loose skin. nothing dramatic. mostly around the gut and love handles. • I am very sensitive to meds and drugs. I'm not much of a drinker but i like weed edibles - what would give me a mild buzz before gets me quite high now. I sober up quicker now too. I take xanax on flights to help sleep - i take a quarter of the dose now. • I drink red wine socially and now cannot really get drunk. I sober up quite fast but get a mild buzz pretty quickly too. • Dumping sucks but it should not be a discouraging factor. Its not life ruining – anyone who’s had a hypo as a diabetic it’s a bit like that with some gastro thrown in. It resolves pretty fast (30ish minutes for me) and is a self-reinforcing feedback loop for shitty food behaviours. For this reason alone I consider the bypass as the better choice for me. • I’ve lost a fair bit of muscle tone and will need to somehow up my protein and start some weight training to recover it. This needs to be balanced with not losing for further weight. • I have to remind myself to eat. Not just because of low appetite, but because once my pouch shrinks for a day then eating again can be uncomfortable and time consuming. As long as I eat fairly frequently my pouch is all good and I can eat quite a lot pretty fast – forget about it for 2 or 4 hours and I’ll need to take some time to eat a bit and get my appetite back. • I was hungry for 33 years and bordered on a pathological inability to waste food. I ate my meal and anything my wife or kid didn’t eat. I’d eat a meal out, go home and have a sandwich. We ate at bars and pubs because the servings were larger. I would eat until I was very uncomfortable if the portion was large enough. Now I still can’t bring myself to leave food – so I have this silly aversion to ordering anything more than something off the appetisers list. I don’t like asking for to-go containers (it’s an Australian thing – it’s really stupid because we pay so much for food out we should keep every bloody morsel) but have started to now order what I actually want instead of what I think I can finish. It’s funny – I went from ordering what I thought would be the biggest portion so I didn’t feel hungry (instead of what I thought looked good) to ordering what I thought I could finish and not waste. Regrets? None to speak of specifically. In a very minor way travel is less fun. I looooove travelling to southeast asia and the USA and love eating all the different things. My appetite is so low now, and eating can be so inconvenient, that I don’t get to eat anywhere near as much variety when I travel. I was recently in SE Asia and looking forward to a huge array of currys. I ate only two in five days as I had no appetite at all. I just need to travel differently now - actually plan to stop for meals instead of just charging all over a city and snacking on the way. I wish id been more sensitive to my wife's emotional processing of the scenario. She's gone from having the tall, chubby guy that was the physical build she was attracted to, to having a skinny beanpole. This was while she was having our second kid and all the very natural weight gain associated. She's not overweight and is, objectively i reckon, absolutely gorgeous but definitely feels marginalised by the process and is quick to colour me as vain or obsessed with my image now I am buying new clothes. I think i could have been more mindful of what I said or did. She was overwhelmingly supportive though and agrees this was worthwhile. Closing thoughts If you are considering this process and maybe you're on the margins of eligibility my experience would say go for it. my hope here was to give a vanilla experience to the mix, unique only in my taking the more permanent bypass on despite my lower starting weight. Sent from my SM-A705YN using BariatricPal mobile app

OMG! I am weeping hysterically, so very relieved and grateful to have found you all. I had my surgery on May 23 and am not even down 30 lbs. (my ticker includes weight loss from my high of 335 pre-surgery). I have a handful of legit reasons for being a slow loser(PCOS, diabetes, metabolic syndrome, hypo-thyroid) and I have a million pathetic excuses (compulsive eating, night eating, rarely exercise), but I am ready to take it to the next level. I have not come to this board in months and to this May board in much longer because I couldn't take the constant reminders of my "failure." But I am done wallowing in it, and plan to renew my efforts. I plan to come here daily and just wanted to thank you all for being here.

Some patients that undergo weight loss surgery experience reactive hypoglycemia. The following are a few links to this condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ http://www.todaysdietitian.com/newarchives/060415p48tip.shtml https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

It's definitely not a "never" thing for sleeve patients, but it is much less likely to occur in someone who's had a VSG than someone who's had a bypass. I'm sorry it's happening to you! Also, I have reactive hypoglycemia and it feels VERY much like dumping but I've had it for years...happens when I eat simple carbs.

Hi Rev- I am with you to an extent. I have "off" days and have noticed some definite changes with my menstrual cycle (like it lasts forever) and my emotions. I also get weird about food on occasion and will struggle with not being able to figure out what to eat. I've recently gotten that under control. I found I really like Muscle Milk light. So, when I start stressing over what/where to eat and I'm alone I hit the gas station for a Cafe Latte Muscle Milk. Problem solved. I have had reactive hypoglycemia since I was a teenager. For years I've controlled it with diet alone. But, since having surgery I've noticed it is much more prevalent and harder to manage. Feeling "shaky" and "weak" are major side effects of low sugar. Where we differ is that I picked up running about four months ago. I really feel that excercise has helped me tremendously. I agree with the other posters that it's probably time to see the dr. for some bloodwork to rule out any insulin or Vitamin issues. Good luck to you! Amanda

I'm 9+ months out and I still have days where I feel weak/shaky. I talked to my NUT and she talked to me about something called reactive hypoglycemia. Basically what happens that that our bodies sometimes still produce the amouts of insulin that it did when we ate so much more, and it can cause a low blood sugar. I started snacking on turkey jerky during the day, just a piece here and there. and I feel so much better. For me, I also feel really rundown and get winded exercising if I am even a little bit dehydrated. Did you do labs a 6 month out?

From my research, reactive hypoglycemia is pretty common about 18-24 months after WLS. I have it and noticed it mainly at night when I would have a carb snack with my evening meds. I have to have a small amount of protein with every snack and meal.

everyones differant thats for sure..I have hashis..Im on armour for thyroid. 1 side of thyroid is dead and shriveled up the other is enlarged..I was going back on forth from hypo to hyper...now stable on ty med..increasing my calories with non ff items and mainly proteins have worked for me. my plan is more ketogenic with high protein...so far so good. I feel for us with sluggish metabolisms . the ff/low fat/sf diet is what got myself where I was but this isn't the case for everyone though. have you had a complete thyroid panel done lately? I get mine done throughout the yr...just throwing this out there not for sure it'll help or not. I understand the physical limitations I struggle with several autoimmune diseases including fibro it can be brutal some days. I noticed you said a sf/ff greek yogurt? I have been settling for the chobani greek it was the lowest on sugar per serving organic and I eat the kroger carbmaster brands their really good. the chobani is what I make the hubs protein shakes/smoothies out of. I'll have one here and there but barely theres to much sugar for me. the only fruit I keep on hand handy is the green grapes their easy to have. Do you use MFP? maybe start using it again to add up everything and kinda see where your at? maybe? IDK...Im sure you are...just throwing that out there..do you think maybe cutting out the rice cakes even though you dont eat often might make a differance in not such a struggle? I can't have grains or white processed items they were my worst enemy for me. another suggestion thats all...congrats on maintaining I hope I'm as successful as you are! thats wonderful! keep us posted

I am in a very similar situation and am hoping for some advice. I was banded in July 2007 and since then have lost 70 of the 170 of my goal. There was a lot of time in between fills as I moved to Ireland two years after being banded and then to India for six months where I lost 40 of the 70lbs and now I'm back in the US. I went in for a fill about a year ago and then around 4 months ago started having issues where I was vomiting nasty black tar in the middle of the night and had HORRIBLE reflux. Just yesterday it was determined that my band had slipped slightly. My band is now empty and will be for the next couple of months, I only had 2cc in my band in the first place and now my nurse is telling me I can NEVER be that full again :-( this news to me is basically telling me I'll be basically empty forever! I'm so discouraged and I don't really know what to do. Has anyone ever been told after a slippage that they can never be as full as they were when the slippage occurred? Also what are some opinions on why I may be stalled? I was diagnosed with hypo thyroidism and am currently not on medication. (long story short my husband doesn't really understand the culture of being medicated here and he doesn't feel I should be "wasting money" on taking medication for hypothryoidism. He thinks that me being overweight is simply my fault for not eating as well as I could be [even though in my opinion I don't eat THAT badly]) on top of that it's hard for me to get my Protein in because he is also a vegetarian and thinks that meat and cheese is bad for you and god forbid I be able to convince him otherwise. I'm at a loss, I don't understand why I'm not losing anymore and I don't know what to do about my hypothyroidism and I'm not sure what to think about never being able to go above 2cc again either! please help!

I do find that snacking leads to stalls and or weight gain for me. I have to be very careful because I also get reactive hypoglycemia so i pretty much eat very small meals all day long. That is a slippery slope and can feel much like grazing which is the worst thing i can do. Early on while in weight loss mode my nut had me drink milk for a snack. it gives you added Protein, turns to a solid keeping you full for quite a while. And.....best of all you can add different types of tea to it. My favorite all time snack especially in the winter is chocolate chai tea. I use the loose tea version from teavanna and steep it for 3 minutes. It is especially delicious, hits the spot with NO added sugar other than what is in the milk. I use lactaid because i still have a lactose intolerance. If i dont have that, i will eat full fat cheese, pepperoni, shrimp, almonds and sometimes bariatric pal hot chocolate or bariatric pal vanilla capacciono.

Update I I Ok so the Doc says I have severe obstructive sleep apnea with low oxygen and failure to up oxygen levels after an apnea event, plus hypo ventilation. So I am waiting to be fitted with a fashionable CPAP machine as we speak. Lovely. The only thing I can do is turn around my attitude, so I am happy that we have discovered the problem, that the office is working my insurance issue and that I may experience what I have read can be life changing sleep after receiving this machine. And guess what? I get to install it myself :-D

Quoted Betterthe Bean Just curious.....which doctor said this? You've stated so many times how bariatric surgeons in this country don't know anything, so how could the surgeon who doled out this little gem about hypoglycemia 30 years post op be trusted to know anything at all? Perhaps he's just as ignorant as the rest of the bariatric surgeons we used. After all, where are his YouTube videos backing up his claims? Hello...ButtertheBean, If you read my posts carefully I've NEVER said ALL US Bariatric surgeons don't know anything, I said to always question surgeons and get second opinions if necessary and ALWAYS be proactive with your own health. Regarding Hypoglycemia - Yes my older sister had stomach stapling surgery over 30 years ago when she was 24 years old, (similar to the Sleeve) and she has had part of her stomach removed as well she she developed ulcers from the stomach staples years ago. She's had those hypoglycemia attacks for many years, but not to the extreme as she is having them now. I've seen how she has lived with this surgery over the years and she's had many stomach problems and pain, however she's never had a problem so severe that required hospitalization, she did have to get her gall bladder removed years ago also. Now she has started to get scared for her life because the attacks are more frequent (daily) and it is causing her to be disabled, she gets really hot, dizzy and her blood pressure drops to almost fainting, a few weeks ago at the casino she fell over people and could not make it to the ladies room, they had to call the paramedics, long term Hypoglycemia can be deadly. She has been to several specialists and they got no answers, only to tell her to keep a strict diet, and she can't eat many carbs without feeling sick, and now have to keep candy and crackers with her at all times, to combat the severity of the attacks, this is when the Bariactric surgeon told her that this can happen with any stomach stapling surgery such as VBG, Sleeve, RNY or DS since the stapled small stomach causing rapid emptying of the stomach that can create these bad side effects, but in many they can get chronic and debilitating over the years. Many Sleeved friends of mine complain of (dumping like syndrome) which is probably Hypoglycemic as well. There are clinical trials right now being done on Bypass and Sleeve patients for long term Hypoglycemia Here are links to some of the studies. http://clinicaltrials.gov/ct2/show/NCT01581801 http://www.ncbi.nlm.nih.gov/pubmed/22773085 The primary aim of the present study is to conduct a 1-year randomized trial to compare the incidence of hypoglycemia after RYGB or SG. Condition Intervention Obesity With Complications Morbid Obesity Reactive Hypoglycemia Bariatric Surgery Procedure: Gastric Bypass Procedure: Sleeve Gastrectomy Study Type: Interventional Study Design: Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment Official Title: RANDOMIZED CLINICAL STUDY COMPARING THE EFFECT OF ROUX-en-Y GASTRIC BYPASS AND SLEEVE GASTRECTOMY ON REACTIVE HYPOGLYCEMIA Resource links provided by NLM: MedlinePlus related topics: Diabetes Medicines Hypoglycemia Obesity Weight Loss Surgery U.S. FDA Resources Further study details as provided by Catholic University of the Sacred Heart: Primary Outcome Measures: incidence reactive hypoglycemia [ Time Frame: up to 12 months ] [ Designated as safety issue: Yes ]The Primary Endpoint of the study is the incidence reactive hypoglycemia within 1 year after the bariatric surgery. Secondary Outcome Measures: insulin resistance [ Time Frame: 0,1,3,6,9, and 12 months ] [ Designated as safety issue: Yes ] Changes at 1 year of insulin sensitivity and insulin secretion measured after an OGTT. Changes at 1 year of body weight, BMI, abdominal circumference, body composition, lipid profile and cardiovascular system abnormalities. the incidence of severe hypoglycemia or related symptoms (shakiness, sweating, dizziness or light-headedness, confusion, difficulty speaking, weakness, confusion, syncope, epilepsy, seizures) within 5 years after the operation. Estimated Enrollment: 50 Study Start Date: October 2012 Estimated Study Completion Date: December 2014 Estimated Primary Completion Date: August 2014 (Final data collection date for primary outcome measure) Arms Assigned Interventions Gastric Bypass25 subjects obese subjects with complications or morbidly obese subjects will be assigned randomly to this arm to undergo gastric bypassProcedure: Gastric Bypass Roux-en-Y Gastric Bypass This laparoscopic operation includes the division of the stomach in two parts. A proximal, smaller pouch (20-25 cc volume), is connected to the rest of the gastrointestinal tract through a gastro-jejunal anastomosis, whereas the distal gastric pouch is left behind but excluded from the transit of food. An entero-entero anastomosis, with a Roux-en-Y type of reconstruction, allows the bile and pancreatic juices to mix with the nutrients at about 100-150 cm from the gastro-jejunal connection. Sleeve Gastrectomy25 subjects obese subjects with complications or morbidly obese subjects will be assigned randomly to this arm to undergo sleeve gastrectomyProcedure: Sleeve GastrectomySleeve gastrectomy Laparoscopic SG involves a longitudinal resection of the stomach on the greater curvature from the antrum starting opposite of the nerve of Latarjet up to the angle of His The final gastric volume is about 100 mL.

Dumping is really rare with the sleeve even though some report it. Considering only 30% of RNY'ers dump, the % is even lower for VSG'ers. However, I developed lactose intolerance and your symptoms sound more like lactose issue rather than dumping. I was able to eat cheese and yogurt, but milk would do me in every time. Reactive hypoglycemia can also be common with the sleeve especially further out, when you have heavy fat or sugar foods after months of not consuming those foods. The lactose intolerance lasted for about a year for me post-op, and I still couldn't drink a lot of milk, but at least I could have some. Around the 3rd month of my pregnancy, it's back in full swing.

I do not have reactive hypoglycemia . . . I am a full-blown diabetic . . . and for that reason alone, I should not have tried drinking chocolate milk (I had a serious moment of weakness!). My blood sugar was high for a couple of hours after that episode . . . But it's interesting that what some people mistake for dumping does have another possible cause.

I have been hypothyroid for many years, had the surgery 10/31/12 and lost 107 lbs. Last March I became hyperthyroid for some reason for a few months, then dropped and became very hypo again. The endocrinologist says she has no idea why it happened. I think it really contributed to hair loss, but not too much to weight loss. She put me on tirosint, a thyroid replacement medication that is more expensive but believed to be better absorbed in our small stomachs. My levels have been steady since. The thought is that once one has thyroid problems they are more likely to have more thyroid problems down the road. We just have to stay vigilant.

I am absolutely not a doctor but I have experienced late dumping several times. Twice after eating white rice, once from eating a baked potato (both simple carbs) and in all cases about two to three hours following eating. Late dumping is usually the result of reactive hypoglycemia. The first time I had it I checked my blood sugar and it was 37. The majority of folks (about two-thirds) who experience dumping experience early dumping. The remaining one-third experience late dumping. And it's important to remember that many never experience dumping at all. Here are a couple of links, one from WebMD and the second one from the University of Rochester Medical Center describing dumping (including late dumping). There are many more. http://www.webmd.com/digestive-disorders/dumping-syndrome-causes-foods-treatments http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=134&ContentID=107

All us HYpos. Need to support each other..Im so worried it wont work...im doing everything tight I was sleeved 4/24. Lets all be each others support team...we are slow looser from what I read but truth is I was not looseing before sleeve I was gaining.13 lds last year 15 each year prior..so looseing steady even if its only 2 a week. Ill take iy...any one haveing issues with hiccups or gas in shoulder....also are u crushing your thyroid or taking hole.