Hypoglycemia & WLS

A question came up on our Texas OH board in April & again today regarding the test for hypoglycemia... I emailed my sister in law who has been a lab tech for 20+ years... (I call her *Dr. Dorothy* LOL) Below is her response AND if your physician is considering putting you through the test, copy this post & take it to em!! Hugz n Texas Blessings, Cath 1. I cannot imagine any Dr. doing a 6hr. GTT on someone who has had a gastric bypass. 2. There are other ways of determining if someone has hypoglycemia....such as a fasting and 2 or 4 hr post prandial glucose...as well as doing a blood sugar when someone is experiencing symptoms. 3. Also, a fasting insulin level should give a clue as to whether something is amiss. Glucose tolerance tests are becoming somewhat antiquated for diagnosis. If I were in her position, post-gastric bypass or not....I would suggest trying to go on a diet specifically for hypoglycemia, and if the symptoms subsided, then continue on that course. If not, then let's look for another cause. The truth is, that there is no real treatment for hypoglycemia other than dietary management, which most post-gastric bypass patients are on anyway. Small, frequent meals low in simple carbs, and higher in protein and grains. Frankly, if the doc knows her entire history (gastric bypass, etc), he/she should not even consider doing this test. It is a rough test to endure even for someone who has not had the surgery. I should know. I had one years ago. And believe me....knowing that she has had the bypass...I can tell you she WILL NOT make it past the first hour without throwing up and voiding the entire test....it is just now worth it. She is not overly concerned for nothing.....she should stand her ground and refuse the test. If the doctor does not understand, then she should find another doctor! Dr. Dorothy P.S. One more thing.....YOU be the judge....I'll tell you the procedure, and you tell me if you would be willing to take the test. You go to the lab after a 12 hour fast. Then a fasting blood sugar is drawn. You are then given 10 ounces of a carbonated beverage which contains 100 grams of sugar. You have less than 10 minutes to consume the entire bottle. A timer is then started and blood is drawn for a blood sugar level at 1/2 hour, 1 hour, 2 hours, 3 hours, 4 hours, 5 hours, and 6 hours. You cannot have anything to eat or drink during this period. Oh, and by the way, the drink tastes AWFUL. Usually orange flavor is used, but it comes in cola flavor, orange flavor, grape flavor and lemon-lime flavor. It tastes like a slightly flat soda with lots of extra sugar syrup added. Would YOU attempt it just to determine if you have hypoglycemia which is only manageable by the correct diet?????

For us it would be more of a DUMP test! I do have hypoglycemia. At first post-op, I had much less problem than before surgery, but I tend to notice more of a blood sugar rush after eating followed by a low these days. I'm sure it is because I am looser with the carbs. I always think "this much wont hurt" then want to take a nap after eating. You'd think I'd learn! And, no! I would not take the glucose tolerance test now! Joy

Wow... that "test" sounds like torture. I also get scared after I donate blood, they try to make me eat baked goods to prove that I'm okay.. I bring food with me - or else I'll die. -Jen

That is interesting. I asked my doc about giving blood and he said to keep my blood--that I will be too prone to anemia to even consider donating any more. I wonder what other doctors are saying? Joy

Thanks Cath! That's one test I think that I'll steer clear of!! Mike

I can't imagine any doc telling someone that has WLS to have this test done. 1) Most of us do not drink carbonated beverages 2. The sugary stuff would probably make her dump 3) most of her hypoglycemic is probably from eating carbs & not enough protein. Which can be resolved very easy by eating more protien or adding protien shakes into the equiasion. This test would be totally insane. Marilyn, the Bearlady

I wouldn't take this test. I have hypoglycemia after wls and it usually happens when I have not put enough protein in my diet. You are correct that there is no resolution other than dietary which we pretty much follow anyway. I go to an endocrinologist who said testing me wouldn't be worth it since I would have difficulty with the test and it is only corrected through dietary mean anyway. So he suggested that I watch my carb intake and up my protein intake. When I have an episode orange juice helps but then I will eat some protein to maintain the level. The key is to get it up quick and then maintain. Hope this helps.

Hi Cath, I hope this note finds you well and healthy. The March 2004 board needs your help! Please visit the board and click on the post, "AND THE SURVEY SAYS" - we will all benefit from your response. Thanks so much. Maureen