Hypoglycemia: In Search of Answers

Hi everyone,

I am looking anywhere for answers...and thought this might be another avenue to start. I had an RNY in 2011 and have been suffering from many complications. Some of which I have been able to deal with and others I have been to several other doctors to try to get help. I knew going into the surgery about possible vitamin deficiency and I understood the need for supplementation which I have been doing. I have needed 4 rounds of iron IV just in the past year, I am taking B-12 shots, and my calcium is out of wack. These things have been working on with the Doctor and I hope they are improving. Not long after surgery, I began to have bouts of dizziness, confusion, heart racing, sweating, and blue-color to cover my vision. I thought it was stress or school, but it continued to become worse. One day I passed out and when they took my glucose it was very low. After that episode, it began a trial and error and several doctors who would not listen to find a single doctor that would. The one thing I cannot control is hypoglycemia. I now have been working with now my 4th Doctor in trying to control and manage it. I was not diabetic or had any health issues prior to the surgery other than I was obese. With the dietician and the endocrinologist we have formed a diet and amount that has helped improve my bouts of hypoglycemia, but I am at the point I can neither trust myself to drive let alone work. I wear a freestyle libre a continuous glucose monitor and it helps but isn't always trustworthy at the levels of constant lows that I am at. Every single time I eat I have a spike in glucose (my body does not tolerate even going higher than 120 or I am down into the '50s within the next 45 minutes to an hour. I carry glucose gel and have tablets everywhere I go. The lowest known glucose I have had was 20. I have passed out or nearly passed out from this several times. I'm just wondering if there is anyone else here like me or experience these glucose events and what you are able to do in order to either sustain your glucose or not have the rise and fall? I do not drink with my meals and my dietician has stated I must wait one minute before each bite and I have been timing myself as well. If anyone would have ANY additional insight, information, or just letting me know I am not alone would be such a blessing. Thank you in advance for any input.

Do you know if yours I regular hypo or reactive or a combo of both?

eating balanced usually helps. What are your meals like? Eating very 3-5 hours as well.

They initially said that it was reactive, but did not have an explanation as to why I drop so low at night and when I do not eat. They are now saying it must be some type of combo. The nutritionist has put me on a diet that is primarily protein and vegetable with fat and carbs added in with very strict amounts of food. I cannot eat most fruit. Very limited caffeine. I have to eat at least every 2 hours or I will drop as well. They have put me on a medication that was supposed to help extend my glucose level at a higher level and I take it three times a day with meals. I cannot exercise more than 10 minutes or even take the trash down the driveway because I drop as well. I passed out trying to take out the trash on the driveway. I spoke with a doctor about reversal (something I did not want to do) and he believes that even with a reversal this may not fix the issue. I feel like my life revolves around food. Thank you for your message...I've never met anyone that has had this issue and I have felt very isolated.

I have RH. Eating something every 3-4 hours has pretty much resolved the problem for me, but it sounds like you have a more severe case. Hopefully they can find something that works for you...

Oh! You have something similar, wow! Sorry, I haven't met anyone that has experienced something like this and I feel so relieved. What type of foods do you eat when you do to help you maintain your issues? What do you do when you go hypoglycemic? Are you able to exercise? What do you eat prior to exercise? Sorry, if I have too many questions!

Here's the thing: I'm guessing you have a glucometer. You can do the best research by using it.

I really suggest eating balanced with carb and protein but more Protein. Then adding in some good fats as well. The more balanced you are with every meal, the more your blood sugar should stabilize.

are you on acarbose?

Yes, I have a glucometer and a continuous glucose monitor that I use to follow my glucose and to watch my reaction. I am currently on acarbose, but it generally hurts my stomach and I have difficulty eating because of the abdominal pain. I am on a very controlled plan from a dietician and although it helps so many things I have cut out from even that plan because of continued highs and lows. Primarily I eat no fruit except a small apple or 1/4 of a banana every other day. The hardest part is waking up in the middle of the night with lows or waking up to find I have been low all night and in a cold sweat, shaking, and unable to walk. Protein and fat are the primary groups in my diet now. I will watch my diet more closely.

I agree with Dawn.

my PCP recommended that I eat a protein - or if I eat a carb, then pair it with a protein - every 3-4 hours.

RH isn't all that uncommon after weight loss surgery. Several of us here on OH have it. It seems to start up a couple of years after surgery.

I don't think mine was as severe as yours. I just got light-headed and dizzy a couple of hours after eating - esp after eating simple carbs. It took awhile to figure out what was going on, I had a complete workup once, but all the tests came back normal. But the next time I had an episode - which was about two hours after I'd eaten a piece of cake - we knew what was causing it (at the time of my workup, my glucose level was normal, so that's why they couldn't figure out the problem until later, when I had that episode after eating cake).

as for foods, I really limit my sugar intake now (which I should be doing ANYWAY), and, as I said, I try to eat something every 3-4 hours to keep my blood sugar stable. And yes, I exercise. I don't really eat anything specific before exercise, but I don't exercise on an empty stomach. I usually exercise within an hour or so after a meal or snack.

Thank you for your reply, I just wasn't sure where to turn. After trying so hard to speak with many different doctors and how they treated me during the beginning of this process I felt so alone! I'm hopeful that once I get more stable I will be able to exercise and build up my strength. I will remember about exercising closer to a meal.

It's very common actually and most of us control it with diet. Mine has never completely resolved, but thankfully is manageable.

Please don't ever let anyone pull you down the rabbit hole of removing part of your pancreas, which I know some have been persuaded to do - very dangerous solution.

Follow the dirt given to a t and you may see a resolution.