Let's talk about Reactive Hypoglycemia

[Wallflower7522 328]

Does this happen to you? I had my RNY in March of 2014 and some days the struggle to keep my blood sugar steady is a challenge. Sometimes it is because I eat too many carbs in a meal, but sometimes I can have a balanced Breakfast and I still get shaky after an hour or two. I'm getting much better about managing it.

Here is the thing I can not figure out. I have a diagnosis of ADD. I take Adderall (which is a stimulant) but the side effects in combination with my dietary needs can be hard to manage so I do take days off. But the strangest side effect of all is that when I'm on it my blood sugar stays very steady. Initially I thought it was because I'm eating a lot less but I can eat the same thing for Breakfast and my blood sugar will drop a few hours later if I haven't taken the Adderall. My other other hypothesis is that I'm much more active on weekend mornings than I am on work day mornings so maybe that's causing my blood sugar to drop faster. I really have no idea but I'm thankful for the unexpected side effect.

So anyone else struggling with this? It's a pain, like when I blacked it at the gym or almost passed out getting tattooed, but I am slowly learning to manage it.

[sharkgirl 251]

Yes, I struggle with it too (have since surgery) and I can't figure out a correlation to when I'm going to have a low blood sugar event. I have figured out the best way (for me) to quickly fix is a about 2 oz of juice and then I'm good.

[VSGAnn2014 12,992]

As I understand it (purely from reading research studies, not from personal experience), reactive hypoglycemia is a post-WLS condition more likely to occur in RnY patients than sleeved patients, although it's not unheard of among sleevers.

Sorry you guys are having to deal with this. Best to you.

[KristenLe 5,979]

@@Wallflower7522 Do you check your blood sugar when you feel shaky? It wouldn't surprise me if Adderall helped stabilize blood sugar. You may want to also check on your blood pressure and be sure to drink plenty of fluids.

[miiasan 370]

if you are not already - you might try to eat 6 small meals that are balanced in Protein and carbs - this might help to keep you steadier. It has been awhile since your surgery - have you talked with your NUT or doctor about this. Having juice around really helps get the blood sugar up fast, but be careful not to drink too much as you might cause it to swing way up and then crash later. Also remember to always eat Protein after the juice - it helps to keep the sugar more level.

My daughter and husband are both type 1 diabetics - so have had a lot of experience with low blood sugars. I don't know if you still log your food - but that might be a good idea for awhile - You also might want to keep a log of the low blood sugars and how you treated them so if there are any patterns they can come apparent. Then take all that info to your doctor and go from there. Low blood sugars can be dangerous - especially if they happen when you are sleeping.

Good luck - and hope you can get this resolved soon.

[Renkoss 420]

Are you on insulin at all? What about meds for blood sugars? I'm a Type 2 who was severely insulin resistant, but my blood sugars are much better since surgery. I still use insulin, but only for basal now. I've lowered it once already and may have to lower again soon as my morning numbers have been in the low 70's. You should always have a glucose meter with you so you can check your sugar, and carry glucose tabs to help raise your sugar. Keep in mind that it will take 15-20 minutes for your body to react to the input of sugar before you start to feel better. There is also a glucose gel that is in a tube or small jar that you could carry around. I keep glucose tabs in my car, in my purse, and I have the gel at work. I've instructed my boss what to do if I become unconscious or loopy from a low.

Always need to be prepared.

[Moogle 116]

I had the hardest time getting out of bed today. When I did, my eyesight was blurry and kept seeing "stars" in like 50% of my normal vision. Went to take my meds and check my sugar - 52. I've never seen it this low. Took a glucose tab and everything is fine now, but still feel a little off. Before my surgery, I was taking Humalin, Humalog and Metformin. Doctor took me completely off of the latter two pretty much. Think its time for a new appointment because I think the Humalin needs to be adjusted next. Over the last week I've seen my morning numbers go from 100-115 to 75-90.

[Djmohr 6,965]

Yes......I defiantly have problems with this. Last week I had an episode and because I am coming off some medications thought it was from that. Before I realized that my sugar was too low, I was in a very confused state, home alone, shaking like a leaf.

For one second my brain thought maybe this is actually your sugar. I took it and it was 47! That was the lowest it ever has been.

Why it happened that day I don't understand. For me it happens when I choose to have oatmeal or cream of wheat for Breakfast. I know that I need to make sure I have a mid morning snack heavy on the Protein followed by a heavy Protein lunch. If I do that, I don't get it.

This particular day I was very focused on high protein low carb. I simply do not know why it happened that day but when it does it is scary how fast you crash and how confused I become.

I have been told by my Bariatrician that it is best to really stay away from carbs in general. The problem for me with that is I am in maintenance and having a difficult time to stabilize.

I am supposed to be maintaining and have lost 8lbs in the last 3 weeks. I also contribute that to some of the medications I was taking that I am no longer taking.

I think this could be a vicious circle for me. I am now 159, strarting to move toward the lower end of the BMI scale and honestly feeling too thin at this point. If I lose below 155 I am going to get really nervous......

[Renkoss 420]

Djmohr, that is very scary when your blood sugar drops like that. When you eat oatmeal of Cream of Wheat, do you add any Protein powder with it? I use the Kashi Go Lean Very vanilla Oatmeal, and I add a scoop of vanilla Muscle Milk Protein Powder to it so I'm getting Protein. I haven't done the cream of wheat yet, but might try this weekend.

I've had where my blood sugar dropped to 45 before (not since surgery though). It is not a fun feeling, and it would drop just like that...no warning. Always carry around those glucose tabs!

[Djmohr 6,965]

@@Renkoss

I learned my lesson that day with the glucose tabs. My sugar was too low, I couldn't find them and I don't keep juice in my home.

I literally tore the cabinet apart and found them and then even struggled to open the container because I was shaking so bad.

Now, they sit right on my end table. They are opened and ready to use.

I do not use Protein powder at all. Because I have kidney problems I have to be careful not to have more than 70 grams of Protein per day. I get that between my one premier Protein shake that I have every morning religiously and my other meals. I have oatmeal or cream of wheat very rarely when I have a craving for it and have learned that I just need to make sure I get that protein snack between.

I have found that if you let more carbs into your diet on a regular basis the chance of you developing reactive hypoglycemia is much higher. I try not to let that happen but there are days I simply want something besides protein and veggies. I eat a lot of fresh fruit, dehydrated apple chips and once per day I have a starch in one of my meals. My nut believes in a balanced approach vs. just protein and veggies and so far it has worked for me.

Thankfully I only experience that reactive hypoglycemia on occasion. The bad part is when it happens you can actually cause it to go on all day. I have learned to stop it as soon as it happens.

[Wallflower7522 328]

I try to eat frequent small meals and have a good carb/fat/protein balance. I don't eat much meat, my normal Breakfast is usually Peanut Butter and wheat toast. That keeps me pretty stable. I also try to watch my caffeine intake as it sometimes makes me shaky. I was not diabetic before surgery, so I don't have a monitor but I need to get one and keep track. I have talked to my surgeon about it and his advice was the small frequent meals.

I do drink a ridiculous amount of fluids which seems to help. Adderall is a diuretic and can cause electrolyte imbalance so I drink a ton of poweraid zero, G2 (sometimes) and propel.

Edited June 27, 2016 by Wallflower7522

[foodfighter78 258]

I just had 3 hypoglycemia crises in 2 days, never had them before. My diet is the same for month and months, RNY March 2015, I'm at my weight goal, maybe little under, working out 5 days a week. So I'm confuse about this. I get super shaky, sweaty, blurry vision, if I close my eyes I see stars, the day after I'm very dizzy, can't concentrate. It's kind of scary feeling. Like I can't control my body. What do you guys do when you get a crisis? I never suffer from diabetes. I eat Protein first, then veggie. I'm very restricted and can't eat much so I make sure to get my protein first. Last crisis I was eating watermelon but I eat that before and no such reaction.

[foodfighter78 258]

Yes, I struggle with it too (have since surgery) and I can't figure out a correlation to when I'm going to have a low blood sugar event. I have figured out the best way (for me) to quickly fix is a about 2 oz of juice and then I'm good.

My problem with all juices is the I get dumping syndrome. Is orange juice ok? Like a freshly squeezed one sugary things makes me dump and I been avoiding it since surgery

[miiasan 370]

@@foodfighter78 I always keep Peanut Butter and crackers around to use if my sugar drops - as far as the juice goes - .. try keeping diluted apple juice around - half water/half juice - cuts down the sugars that could cause you to dump, but should give you enough to braise your sugar a bit - then be sure follow that up with a carb/protein snack to keep your sugar from plummeting again. Hopefully everyone who is having low blood sugar episodes is following up with their doctor. Low blood sugars can be very dangerous -

[foodfighter78 258]

@@foodfighter78 I always keep Peanut Butter and crackers around to use if my sugar drops - as far as the juice goes - .. try keeping diluted apple juice around - half water/half juice - cuts down the sugars that could cause you to dump, but should give you enough to braise your sugar a bit - then be sure follow that up with a carb/protein snack to keep your sugar from plummeting again. Hopefully everyone who is having low blood sugar episodes is following up with their doctor. Low blood sugars can be very dangerous -

Going to the dr on Wednesday