Hypoglycemia: In Search of Answers

Thank you for the insight! I did have a doctor recently asked me to start thinking about a partial or full pancreatectomy! I was really surprised at this mentioning. It was that or a reversal of the RNY put together. Both sounded rather scary to me in the first place. I'm going to follow the diet more closely and see if there is anything else I can catch.

Hi there -

So sorry you're going through all this. I have had RH since early adulthood (before I was obese) and it got worse after surgery, about 2 years post-op. I've done a lot of research on this and realized that most doctors have no clue about it. A few things I've picked up along the way that might help.

• Have you tried really reducing your carbs to put your body into ketosis? You may be super-sensitive to carbs -- even if eaten with protein.
• Find an endocrinologist that understands hypoglycemia (but it sounds like you're getting good medical care)
• I found the Freestyle Libre to be wildly inaccurate and switched to the Dexcom 6. It was a game-changer for me as it gives me real-time, continuous results without having to do a scan. It's much more accurate and has given me great insights into my diet. You may need to battle your insurance company to approve it.
• My doctor put me on Ozempic and Saxenda (I had to switch due to insurance plan changes). I understand they are a new class of diabetes drugs but what they do is slow the gastric emptying. It has helped me (and is helping me lose the 25 lbs of regain).

Again, you may need to battle your insurance company for approvals on these, but if you have a doctor who is willing to fight the fight you may get these approved. Some doctors are more tuned in to these newer technologies and drugs than others. I ended up switching bariatric centers from the one who did my surgery because the doctor told me I didn't have RH when I knew I did, and she wanted to put me on Metformin, and the new doctor was perfectly willing to prescribe me the Dexcom where the first didn't see the need.

I hope these suggestions help... my lesson in all this is that I had to get educated on options and keep searching until I found a doctor who listened to me.

Wishing you the best and sending a virtual hug!

Lisa

Lisa,

Thank you from my entire heart for your reply and all of your suggestions and information! I suffered from hypoglycemia for two years and going to doctor after doctor to even find someone to believe me in the first place. I have reduced my carbs to a very low cab diet, but I think I will take your advice and try even lower or to cut completely. I will do some research on the Dexcom and see what insurance may pay. I have been concerned about the unreliability and have contacted Abott several times with my concerns. Also, at my next appointment, I will ask about the other medications you have mentioned as well! I truly appreciate everything you sent!

I wish you continued success and a virtual hug back to you!

Hypoglycemia after WLS, especially RNY is not uncommon. There is the RH type based on something you ate several hours before that spiked your BS and then it drops.
And then nondiabetic hypoglycemia which isn't necessarily based on eating a specific sugary item or something. I have both. Sounds like you do too.

You have to be your own detective and figure out what works. I needed to listen to professionals outside of Bariatric world. People smarter than me I like to say.

I accepted with trepidation and it took awhile for things to even keel. It involved eating very regulated - as in every 2-3 hours. I eat 5-6 times a day whi*****ludes protein drinks. Sometimes I feel like all I do is eat. I eat very high protein but did have to add carbs in. Eat lots of veggies too. That was part of the equation. I have Casein protein every night before bed. This is a slow digesting protein that digests over 7-8 hours. I think that helps overnight. I pretty much pack food with me in a lunch bag wherever I go.

Good Luck!

What's your eating like in a day?

So I follow the diet that was provided by the dietician and trying to eat around every two hours. When I walk in the grocery store, take out the trash, or do minimal exercise I will have to eat almost as soon as the activity is done. Here is my full meal plan from yesterday. Yesterday was a better day. Sometimes I try to copy meals to the exact thing the next day just to see if it is possible to replicate a good day, but it doesn't always work.

"Breakfast"

2 slices of keto low carb, low-cal bread (0 net carbs)

1 TBS almond nut butter

*Snack

6 unsalted almonds

1 small gala apple (I have fruit every other day)

"Lunch"

2 oz ground 100% white meat turkey (cooked without butter)

1 cup fresh spinach

1 TBS lite Italian dressing

*Snack

4 oz milk

6 unsalted walnuts

"Dinner"

3 oz ground turkey (leftovers from lunch)

2 slices of the keto bread

1 TBS sugarfree BBQ sauce

1/2 cup cooked green beans

*Snack

Premier Protein drink

Everything I eat is measured, counted or weighed. I keep a daily written journal.

I'd be ditching the bread and apple for sure.

Don't do net carbs. That's a trap by manufacturers. Count every carb.

The thing is that we often need a balance. Carbs need to be enough to raise blood sugar. Then protein and fat to sustain. I wonder if maybe you aren't starting your day with enough.

do you test often? I would play and log with my glucometer to find efficient meals to sustain.