Low Blood Sugar Worries

I have my surgery in 2 days and I am worried about low blood sugar.  I am worried that I will crash, that's what I call, it after surgery and what do I do? I will not be able to eat something, OJ, high carb something to bring it back and so on.  I am currently on the pump and they want me to disconnect the morning of surgery. My A1c's have been running 7.1, but I know it's even better now since I have lost weight and had to back the pump down some.   The doctor has assured me the hospital will be monitoring my sugar and will make sure I don't crash.  What about after I come home?  Anybody have any experience or knowledge of this.  Pretty worried about this.

Well, these were ALL my concerns and questions two years ago before RNY.  I am a type 1 and was not on a pump (am now), but on multiple daily injections.  Lots and lots of questions and fears about the issues you raised.

First, you likely will be fine.  Because you will be eating so little initially, your insulin needs will be much less than they are now.  I would STRONGLY recommend that you have a consultation in the hospital with an endo and that the doctor follows you while you are in the hospital. Then, you should schedule an appointment with your endocrinologist for as soon as you are discharged, so that you can work closely on a plan that will work for YOU.  I was fortunate as my endo gave me his cell #, and we texted in the hospital and he saw me the day after I was discharged.  Demand attention - you will need it, as you likely will need to make big changes in your basal rates when you reconnect to your pump.

Secondly, and most importantly, you will need VERY LITTLE to bring you up again should you go low.  And you can have liquids, so a little juice or milk will be fine to bring you up.  Honestly.  What you are used to now is probably way too many carbs - and about an ounce of juice will fix your low (and will not cause dumping because it is such a small amount, so don't worry about that).  You should also have glucagon around in case of a big emergency.  I did, but honestly, I did not need it at all.

Frankly, lows will not be a problem in the early weeks.  In order to get all of your protein and fluid in, you will have calories going in constantly - all day long.  In fact, you might drift a little higher because of that.  And, you and your endocrinologist may decide that running a little high temporarily is better than running low.  I am used to eating three times a day and those early weeks were tough because you are taking in calories/liquid constantly. Because you are on a pump, you have the ability to make very fine adjustments hourly if needed.  Take advantage of that and work closely with an endocrinologist to manage.

They will monitor your blood sugars during surgery and will address any problems.  I emphasized with everyone, including the anesthesiologist, that I wanted this done.  And they will do it.  I know it's hard to turn that over to someone else, but it will be OK.

I am sure you will be fine.  But, truly, I understand since I went through this exact thing two years ago.  Just be assertive - oh, and take your pump and meter with you.  Once your surgery is completed and you are awake, they will likely allow you to hook up again.  I had my gall bladder out last year (and RNY two years ago) and, both times, they allowed me to run my own medicines and decide what I needed when.  Since I have 25+ years at it, they realized that I knew more about how my body works than they did.

Congrats on this big step and please ask any questions and let us know how you are doing!

Good luck!

I know I am bumping up an old post, but Thank You!

this information is Very helpful & just want I needed to read tonight

Initial consultation tomorrow morning, nearly 30 years Type 1, insulin pump, fighting daily to not weigh 310

 

if you are getting the sleeve or ds you can just eat some sugary food, candy ect

if you are getting a  rny and you are the 30% that are dumpers , then you will have to be real careful to balance what you eat and talk to your endocrinologist and nut

i am type 2 and have been off my insulin and byetta since surgery just on metiformin my fasting blood stays between 100 -138(mostly 110-120-) my sugar 2 hours after diner is 90-100 mostly , It hit 72 once and 78 a few times but a piece of fruit fixed me right up

 my a1c stating my journey was 7.4, right before surgery it was 5.8 have not had it done yet after surgery it is to soon , but I expect it to be good

are you type 1 or 2

I am type ll. Been on a pump for about 4 years. Since I have lost 50+ #s it seems harder to avoid low episodes. I hope I walk away from the hospital and away from the pump. Thanks for the advice.

Work closely with an endocrinologist or diabetic educator!  You may not need the pump, but even if you do, your insulin needs will change.  It's important to be proactive so you know how to manage this part. 

Rooting for you!!  YAY!

 

talk to your nut you probably need to eat more complex carbs that are slow to break down ,funny my fasting blood in the morning is almost always higher than 2 hours after a meal , my liver must be dumping sugar into my blood

I had my rny surgery Sept 25/13. I am also on a pump. I was the first person on a pump to have the surgery at my hospital. I had a hard time in hospital, even the endo team. They were afraid I would go low. I fought with them and won. You are your best advocate in the hospital, you know what you need. You need to speak for yourself. As for low sugars, I am back on my pump at 50% less insulin than before the surgery. If I go low I take 1tbsp of liquid honey. It is enough to raise my sugar and small enough to "fit" in my new stomach. Thankfully I have had only 1 low. Best of luck.

I have also been concerned with this. I am a type 2 diabetic and have an appointment with my PCA mid November and she watches my sugars closely. I called their office to let them know I have bariatric surgery scheduled for January and they switched my doctor's appointment to a different day so I can have additional time to discuss with my family doctor what we need to do to monitor sugars. I am also having my surgery out of town (Michigan to Texas) so my surgeon won't be monitoring my after care and my PCA will. Will wait to hear from you post-op to see how things went.