postprandial hypoglycemia

 So for me it has been three and a half years since RNY. Down 160 lbs. Never had blood sugar issues when I was 330 plus pounds. Just delivered a healthy baby girl in July...during my pregnancy was my first complication of surgery...or so I thought. It started with me feeling dizzy in the shower and getting real hungry when this happened. I went to my obgyn and she did fasting glucose and A1C. Fasting was 77 and A1C was a wonderful 5.2. I was still getting these feelings of light headedness. The episodes started getting closer together and more severe. At work one day I felt off...just didnt feel myself so I had my clinical lead(I work in a medical office) take my BS...ummmmyeah it was only 39. I had eaten an hour before that...so I was confused.  I called my OBGYN who immediatly set me up with an endo DR. In the mean time my mom,who has Type II and doesnt check her BS let me borrow her meter... well I would be 60 before eating and w/i an hour of eating my BS would be well over 200...then and hour after that it would be in the 30-40 range. Endo Dr started treating me with insulin to keep my sugars from going high and causeing my pancreas to over react. It worked during my pregnancy. Now things are all over the place and my endo as no clue how to treat it. I finally convinced her I need to go to Joslin Diabetes Center in Boston that has a person that specializes in these BS issues in post surgery patients... Hope I dont need to have my pancreas partially removed...I guess this is becoming a complication for people without diabtes before suregery. Anyone else have any advice for this type of BS issue? I changed my diet so much I lost 6 lbs in one week while pregnant. SO that is under check!!

I am not sure about RNY but BGLs over 200 after eating is way too high for a non-D or D. Are you eating low GI foods or does that not matter if you have RNY?

What happens in people (without RNY) is that if you eat high GI foods, the carbs are absorbed quickly and the body makes a truck load of insulin to deal with the increase in BGL. Then because there is too much insulin, the BGL crashes after. The treatment for reactive  hypoglycaemia like that is to stick to a low GI diet. Not sure how that works with the RNY bit.

Hope this explanation helps. I HIGHLY doubt they would remove a portion of your pancreas.

Cat.

  RNY is what causes this. MY food is going into the small intestines way to fast and causes the BS to go way up and then pancreas overreacts and it crashes. It doesn't matter what I eat, I can eat meat and low glycemic value veggies only and it goes up to 175 or higher every time.Problem is most pts with RNY that get these symptoms have small insulin producing tumors caused by rapid weight loss. Actually the cure usually is partial removal of the pancreas. This is all new to medicine, maybe 5 years now, only a handful of Dr's are researching postprandial hypoglycemia in post surgery patients. My case is so severe that I can't eat and drive or feel comfortable being home alone with my children. Also work is out of the question because I have lows so often that caring for my patients isn't wise. I can't wait to go to Boston. I know that MD has different medicines to try. Hopefully I don't need to have some of my pancreas removed, but most endo Dr.s have no clue what to do with patients like me...so if anyone has this happening thing of looking for someone that knows how to treat it...I felt like my endo's guinea pig and nothing she tried worked.

Most people (RNY or no) find a low-carb diet to be key in controlling reactive hypoglycemia. The glucose spike and resulting surge of insulin is usually caused by carbs, not just any food. Many have the misconception that only SUGAR is dangerous, but for most folks with these types of issues, it's essentially any carbs, including whole grains, potatoes, fruits, etc.

 That is what dumping syndrome is. For me even with strict diet of low to no carbs I have extreme swings in blood sugar That did not happen the first 3 years then out of nowhere it got really bad. I can eat chicken and salad and my BS goes to 200....so aweful. 

I have the same symptoms. I cannot eat more than 4 carbohydrates without a spike and then crash. The blood sugar swing causes severe headaches and migraines. My endo wants me to take insulin but I find that the timing of the insulin action and my digestion (RNY2006) don't match up and I get crazy blood sugar results when I try to use the humalog. My endo won't let me take precose because he says I am malnourished already. Four carbs is nothing. I never eat starches or fruit or vegetables. Just cheese, protein and low carb yogurt. Sometimes I will spike with even 4 carbs. I keep losing weight, 102 now, and the less I weigh the fewer carbs it takes to spike my blood sugar. I am seriously considering a takedown (reversal). My surgeon is confident she can do it. I wish I knew of someone who had a takedown for this and if it helped. I wrote that endo at Joslin three weeks ago, but haven't gotten a response and am very discouraged. Has anyone heard of reversal as a treatment for this problem?

 My endo had put me on insulin too, but this caused me to crash still. I have an appointment at Joslin with Dr Patti who specializes in Gastric Bypass patients with this very issue. Meds she uses are arcarbose and others like that before thinking about sugery. Some people need partial pancreas removal with sucess. If you google Dr Patti and powerpoint her presentation comes up. This problem is making me not be able to work. It is horrible. Im tired all the time.

I am going on my 2nd year of having reactive hypoglycemia. I can only say that I am functioning at this point.. Insulin is not the answer at all most of us take precose or byetta/victozia, these medication slow down the gut activity and thus stop the dumping... I wish that I could give you easy solutions but everyone is different. no carb diets are really not the answer either as complex carbs keep our sugars stable. I know that there is a Dr in clevland a Dr.Shalahi that has been doing research for years on this condition and if you look at my previous posts I beleive her name and number is in there and you can call and they are more then willing to help your endo get you on the right track.... best of luck to you

 I would love to be functioning at this point...the ups and downs really wear on the system. My surgeon was appauled when he found out the endo Dr had me on insulin and immediatly switched me to metformin which I am not seeing any results yet. I see a specialist at the Joslin Diabetes Center in Boston next Friday. She has done alot of research on this as well and I hope she has some answers for me. I can't live like this. Forget not drinking and driving...I can't eat and drive. I have basically stopped driving and if I have appointments or things to do I fast. I'm fine as long as I dont put food in my mouth. I dont even realize my sugars are low until it is the in the 40's or lower. Lowest one I've recorded was 29. I barley made it to ge tsomething. Its very scary! I'm happy to hear there is hope. I'm definatley not alone with this issue...thats for sure. Thank you for your reply.

There is HOPE... and yes many many of us on here are suffering from it.. The worst part I  knew nothing about it until it happened to me and when i went crying to my Bariatric surgion he said" Stop eating sugar!" what the hell he would not even discuss this could be a sideffect from gastric bypass. I went from doctor to doctor and finally was sent to a endo who has one other bypass pt with this as a patient... I am mortified that my gastric bypass doc wouldnt even return my calls after I confronted him on this....I warn you about  the glyco tolerence test if your endo recommends one do not drink the entire 8oz it contains 70  grams or more of sugar and I told him I could not possibly injest that much I would be very ill . After only drinking half I ran to the restroom very ill and my sugars dropped to 27.... the whole time the lab techs kept telling me to keep drinking.... Also make sure you have a snack after test they tryed to give me a coke to drink...lol  I ate a handful of fresh cherries and plunged to 30 within 10 mins ...got to love reactive hypoglycemia!!