Reactive Hypoglycemia After Bariatric Surgery

[RJ'S/beginning 5,358]

Hi;

I have not read about this topic on here and so I thought I would share my latest health issue. I found this article on it and thought others might find it interesting because it does happen to WLS patients more then you think!

What is reactive hypoglycemia?

After bariatric surgery you may experience reactive hypoglycemia:

• Hypoglycemia means low blood sugar

• Reactive hypoglycemia is having low blood sugar after eating a

meal or snack

This may happen after eating foods that are high in sugar or simple

carbohydrates. It is thought to be related to dumping syndrome.

How do I know if I have reactive hypoglycemia?

You have reactive hypoglycemia if you have:

• any symptoms listed below a few hours after having a meal or

snack and

• these symptoms go away after eating or drinking

What are the symptoms of reactive hypoglycemia?

You may feel one or more of these:

• hungry • sweaty

• shaky • anxious

• dizzy • weak

• sleepy • confused

What should I do if I think I have reactive hypoglycemia after having

a meal or snack?

Having low blood sugar is not good for your overall health and can be

life-threatening.

• If you think you have reactive hypoglycemia, check your blood

sugar.

• If your blood sugar is less than 4 mmol/L, you need to treat it to

bring your sugar above 4 mmol/LWhat is reactive hypoglycemia?

After bariatric surgery you may experience reactive hypoglycemia:

• Hypoglycemia means low blood sugar

• Reactive hypoglycemia is having low blood sugar after eating a

meal or snack

This may happen after eating foods that are high in sugar or simple

carbohydrates. It is thought to be related to dumping syndrome.

How do I know if I have reactive hypoglycemia?

You have reactive hypoglycemia if you have:

• any symptoms listed below a few hours after having a meal or

snack and

• these symptoms go away after eating or drinking

What are the symptoms of reactive hypoglycemia?

You may feel one or more of these:

• hungry • sweaty

• shaky • anxious

• dizzy • weak

• sleepy • confused

What should I do if I think I have reactive hypoglycemia after having

a meal or snack?

Having low blood sugar is not good for your overall health and can be

life-threatening.

• If you think you have reactive hypoglycemia, check your blood

sugar.

• If your blood sugar is less than 4 mmol/L, you need to treat it to

bring your sugar above 4 mmol/L. Follow the steps on the next

page.

If you do not have a meter, talk to your family doctor, health care

provider or the diabetes educator in the Bariatric Clinic to get a meter.

When your blood sugar is less than 4 mmol/L:

1. Take 15 grams of a fast acting carbohydrate right away.

This will raise your blood sugar quickly.

Examples of fast acting carbohydrate include:

• Chewing 3 to 4 dextrose or glucose tablets (read the label)

or

• Drinking ¾ cup (175 ml) of juice

2. Wait 15 minutes and check your blood sugar again.

3. If your blood sugar is still below 4 mmol/L treat again with one of

the fast acting carbohydrates listed above.

4. Repeat these steps until your blood sugar is above 4 mmol/L.

5. If your next meal or snack is more than 1 hour away, you need to

have a snack that contains carbohydrate and Protein that fits

into the stage of diet you are at. Examples of Snacks are listed

on the last page.

You may feel like eating sweet foods like Cookies, cake and candy.

Even though these foods are high in sugar and can raise your blood

sugar, your blood sugar will go too high too fast which is not safe. This

can then lead to another low blood sugar because too much insulin is

released.

How can I prevent reactive hypoglycemia?

You can help prevent reactive hypoglycemia by following your diet

guidelines for bariatric surgery.

• eat 3 healthy meals and 2 healthy Snacks each day

• space meals and snacks 2 to 3 hours apart

• eat Protein at each meal and snack time

• avoid skipping meals andsnacks

• avoid or limit alcohol depending on what stage of diet your are at

• avoid or limit caffeine depending on what stage of diet your are at

• avoid sweets like Cookies, cakes, candy, pop, juice and sweet

drinks

Instead of sugars and simple carbohydrates, eat complex

carbohydrates because they release less sugar over a longer period of

time. Having a complex carbohydrate with protein will slow this release

even more.

Try putting any of these together when they fit the stage of

bariatric diet you are at:

Complex Carbohydrates

• whole wheat crackers

• whole wheat bread

• whole wheat pita

• whole grain rice

• potatoes

• Cereal

Protein

• nuts

• cheese

• meat

• lentils

• Peanut Butter

• eggs

• yogurt

Here are some snack ideas to have after treating

a low blood sugar:

• crackers and cheese

• pita and hummus

• nuts and yogurt

• melba toast and Peanut Butter

[Mrs.RRn 2,111]

Luckily, if we are eating as we should, this shouldn't be an issue.

... Put down that cupcake...

[TheNewSusie 471]

I'm a type one diabetic and I balance what I eat to keep my sugar from dropping. Sometimes in uncontrollable and ill drop after eating about an hour later. I have to eat every 4 hours or so to keep this from happening. I'm almost two years post vsg

[cheryl2586 3,053]

Yes I became hypoglycemic after surgery. Its not about eating sweets. None of us can eat enough to sustain our blood sugar levels which cause this issue. I find eating every couple of hours has solved my problem. If I don't then you can find me on the floor. I got smart really quick after the first episode and that my blood work from my doctor my blood sugar was 40 after eating a complete meal. That is another reason Protein is important to all of us.

[RJ'S/beginning 5,358]

Luckily, if we are eating as we should, this shouldn't be an issue.

... Put down that cupcake...

It has nothing to do with cup cakes. It has to do with not being able to put enough complex carbs in your sleeve sometimes to make things work properly. One thing my nut told me is that if you had it before in the past it can rear its ugly head again after surgery.

I started having this when I began training ( exercising ). I had no idea that it would happen to me. Every other issue seems to have leveled itself out. But this one came on hard and fast.

So now Like @@cheryl2586 I have to eat something 6 times a day. the episode I had last was so bad I passed out. Scared the S**T out of me.

My nut told me that it does not happen to everyone but some. Yes it can. I like others are informing that this is a possibility!

Cupcake indeed!

[☠carolinagirl☠ 18,721]

RJ, thanks for sharing this

i have this and as you, cheryl and my dr said, eat often and be aware..and be prepared..

my dr said it occurs (via my case) when people have digestive surgeries...i have had 3...gall bladder removed, hernia repair and lap band plication....its not a fun when it happens and quite scary....now me and hub are prepared where ever we go and have emergency things on hand just in case..

Hi;

I have not read about this topic on here and so I thought I would share my latest health issue. I found this article on it and thought others might find it interesting because it does happen to WLS patients more then you think!

What is reactive hypoglycemia?

After bariatric surgery you may experience reactive hypoglycemia:

• Hypoglycemia means low blood sugar

• Reactive hypoglycemia is having low blood sugar after eating a

meal or snack

This may happen after eating foods that are high in sugar or simple

carbohydrates. It is thought to be related to dumping syndrome.

How do I know if I have reactive hypoglycemia?

You have reactive hypoglycemia if you have:

• any symptoms listed below a few hours after having a meal or

snack and

• these symptoms go away after eating or drinking

What are the symptoms of reactive hypoglycemia?

You may feel one or more of these:

• hungry • sweaty

• shaky • anxious

• dizzy • weak

• sleepy • confused

What should I do if I think I have reactive hypoglycemia after having

a meal or snack?

Having low blood sugar is not good for your overall health and can be

life-threatening.

• If you think you have reactive hypoglycemia, check your blood

sugar.

• If your blood sugar is less than 4 mmol/L, you need to treat it to

bring your sugar above 4 mmol/LWhat is reactive hypoglycemia?

After bariatric surgery you may experience reactive hypoglycemia:

• Hypoglycemia means low blood sugar

• Reactive hypoglycemia is having low blood sugar after eating a

meal or snack

This may happen after eating foods that are high in sugar or simple

carbohydrates. It is thought to be related to dumping syndrome.

How do I know if I have reactive hypoglycemia?

You have reactive hypoglycemia if you have:

• any symptoms listed below a few hours after having a meal or

snack and

• these symptoms go away after eating or drinking

What are the symptoms of reactive hypoglycemia?

You may feel one or more of these:

• hungry • sweaty

• shaky • anxious

• dizzy • weak

• sleepy • confused

What should I do if I think I have reactive hypoglycemia after having

a meal or snack?

Having low blood sugar is not good for your overall health and can be

life-threatening.

• If you think you have reactive hypoglycemia, check your blood

sugar.

• If your blood sugar is less than 4 mmol/L, you need to treat it to

bring your sugar above 4 mmol/L. Follow the steps on the next

page.

If you do not have a meter, talk to your family doctor, health care

provider or the diabetes educator in the Bariatric Clinic to get a meter.

When your blood sugar is less than 4 mmol/L:

1. Take 15 grams of a fast acting carbohydrate right away.

This will raise your blood sugar quickly.

Examples of fast acting carbohydrate include:

• Chewing 3 to 4 dextrose or glucose tablets (read the label)

or

• Drinking ¾ cup (175 ml) of juice

2. Wait 15 minutes and check your blood sugar again.

3. If your blood sugar is still below 4 mmol/L treat again with one of

the fast acting carbohydrates listed above.

4. Repeat these steps until your blood sugar is above 4 mmol/L.

5. If your next meal or snack is more than 1 hour away, you need to

have a snack that contains carbohydrate and Protein that fits

into the stage of diet you are at. Examples of Snacks are listed

on the last page.

You may feel like eating sweet foods like Cookies, cake and candy.

Even though these foods are high in sugar and can raise your blood

sugar, your blood sugar will go too high too fast which is not safe. This

can then lead to another low blood sugar because too much insulin is

released.

How can I prevent reactive hypoglycemia?

You can help prevent reactive hypoglycemia by following your diet

guidelines for bariatric surgery.

• eat 3 healthy meals and 2 healthy Snacks each day

• space meals and snacks 2 to 3 hours apart

• eat Protein at each meal and snack time

• avoid skipping meals andsnacks

• avoid or limit alcohol depending on what stage of diet your are at

• avoid or limit caffeine depending on what stage of diet your are at

• avoid sweets like Cookies, cakes, candy, pop, juice and sweet

drinks

Instead of sugars and simple carbohydrates, eat complex

carbohydrates because they release less sugar over a longer period of

time. Having a complex carbohydrate with protein will slow this release

even more.

Try putting any of these together when they fit the stage of

bariatric diet you are at:

Complex Carbohydrates

• whole wheat crackers

• whole wheat bread

• whole wheat pita

• whole grain rice

• potatoes

• Cereal

Protein

• nuts

• cheese

• meat

• lentils

• Peanut Butter

• eggs

• yogurt

Here are some snack ideas to have after treating

a low blood sugar:

• crackers and cheese

• pita and hummus

• nuts and yogurt

• melba toast and Peanut Butter

[Teachamy 1,042]

I'm a type one diabetic and I balance what I eat to keep my sugar from dropping. Sometimes in uncontrollable and ill drop after eating about an hour later. I have to eat every 4 hours or so to keep this from happening. I'm almost two years post vsg

I'm a type I diabetic too, and since I have to take insulin, my hypoglycemia is usually a miscalculation on the amount of insulin I need to take. (75% less than I used to take) If I bolus for Snacks, I usually experience a mind-shattering low. So I am learning to cut my insulin more and more. Pretty soon I will be taking far less than a diabetic baby. Go figure!

[terrydumont46 1,954]

I have had 2 bad episodes of hypoglycemia. both were when I was still on insulin. I am now off insulin. one of my first symptoms I had isn't listed above. I became very very nauseated and than weak and a bit confused.

[moonlitestarbrite 902]

Hi;

I have not read about this topic on here and so I thought I would share my latest health issue. I found this article on it and thought others might find it interesting because it does happen to WLS patients more then you think!

What is reactive hypoglycemia?

After bariatric surgery you may experience reactive hypoglycemia:

• Hypoglycemia means low blood sugar

• Reactive hypoglycemia is having low blood sugar after eating a

meal or snack

This may happen after eating foods that are high in sugar or simple

carbohydrates. It is thought to be related to dumping syndrome.

yup, i had this when i was pregnant. i highly recommend getting a blood sugar monitor to check blood glucose levels before and after eating and exercise to see how food and exercise affects you. it's different for everyone. some people get high surges and then drops. some people are only reactive to high GI foods, so people are reactive to not eating enough carbs, some people have sudden drops whenever they eat. if you track your BGL you will be able to more easily treat it.

[musiclover 61]

I have never had Hypoglycemia before nor have I ever been Diabetic. I have previously been diagnosed as insulin resistant but since my sleeve surgery a year ago I have recently developed the symptoms and have had a number of scary 'hypo' episodes when commencing exercise especially in the morning. This is causing me great concern, I didn't sign up for this surgery to become sicker than I was before it. I hope I can get some help on how to manage the symptoms as from what I've read up about, many bariatric patients end up developing reactive hypoglycaemia which I had no idea about until I started getting the symptoms. Does anyone know how best to deal with this? I want to be able to exercise but for the last few weeks I've been unable to manage much before the sweats, the shakes, and feeling like I'm going to pass out, and worse I want to eat!! My weightloss is at a stall, nearly 2 months and no change. Would appreciate any guidance.

Please also be aware that this problem occurs to many many Bariatric patients quite often some time after their surgery and from what I've read there is no cure, just guidelines to manage it. Essentially though our Pancreas are delivering too much insulin into our bodies which is what causes the hypo. I'm seeing my surgeon next week for my 1 year review and my GP next week for bloods to see if there is any help I can get for this condition.

[moonlitestarbrite 902]

what is your blood glucose level in the morning? you need to know this and then how to bring it up to normal level before starting exercising. how you treat it will depend on how low it is in the morning.

[RJ'S/beginning 5,358]

It is one of the scariest things I have had to deal with so far..And I have had some dillies. So far I have been managing it not to badly...But the symptoms come on so fast...It rocks everything I am doing...Don't want to have one with my grand daughter in the car while I am driving or when I am baby sitting her. Very unsettling....

[musiclover 61]

what is your blood glucose level in the morning? you need to know this and then how to bring it up to normal level before starting exercising. how you treat it will depend on how low it is in the morning.

I have no idea what my blood glucose levels are as I have no way of checking as have no monitor? I'm hoping my GP will be able to do some bloods and give me some help with this as it really is so debilitating and ruins my entire day even after the initial symptoms have finished I still feel terrible for hours after.

Worse news is my surgeon's office have just cancelled my 1 year review appointment next week as he has an urgent surgery to do and will reschedule me for some time in the future but when I told them about this new condition they suggested I make an appointment with the team dietician. I really do want a medical opinion too though so still seeing GP next week but their knowledge of this surgery isn't great from what I've experienced so far they just constantly refer to guidelines they have about Gastric Bypass.

[musiclover 61]

It is one of the scariest things I have had to deal with so far..And I have had some dillies. So far I have been managing it not to badly...But the symptoms come on so fast...It rocks everything I am doing...Don't want to have one with my grand daughter in the car while I am driving or when I am baby sitting her. Very unsettling....

It is scary instant it RJ? I really can't bear the thought of this being a long term complication of the sleeve and hope we can get some real help and advice on how to manage it. As you say if it happens in a public place or behind the wheel it's awful.

[moonlitestarbrite 902]

I have no idea what my blood glucose levels are as I have no way of checking as have no monitor? I'm hoping my GP will be able to do some bloods and give me some help with this as it really is so debilitating and ruins my entire day even after the initial symptoms have finished I still feel terrible for hours after.

Worse news is my surgeon's office have just cancelled my 1 year review appointment next week as he has an urgent surgery to do and will reschedule me for some time in the future but when I told them about this new condition they suggested I make an appointment with the team dietician. I really do want a medical opinion too though so still seeing GP next week but their knowledge of this surgery isn't great from what I've experienced so far they just constantly refer to guidelines they have about Gastric Bypass.

you have to ask your doctor to write a script for a monitor so you can start checking your BGL. usually the pharmacy has coupons that make the monitor free and insurance covers the strips. if you start checking your BGL several times a day (first thing in the morning, 1 hour, 2 hours, 3 hours after a meal and before bed) you will get an idea of how food affects you and if eating before bed helps how you feel in the morning. i had this issue when pregnant, my GBL was really low in the morning and i would fall over while doing yoga... i learned i needed to eat more carbs than i thought in order to get my level up to normal.

this is not reactive hypoglycemia, its different. the only way for you to know what is actually happening with you is to check with a monitor for a few weeks. good luck!