Help from someone 3 years post op RECENTLY diagnosed with diabetes...

Hi friends, I'm ready to throw in the towel. I was diagnosed with diabetes recently and my main scare is constant low blood sugars, sometimes in the 30s. No matter what doctor I see or what I read I can't get a handle on what I should do. The first doctor told me to eat carbs with protein, like south beach diet, but doing that I have GAINED 25 lbs. I see an endocronlogist in JUNE. Earliest I could be seen. I also had very low iron but with iron infusions and b12 shots that has gotten better. I'm so scared about this diabetes thing. My highs are in the low 200 but then drop really fast to the low 30 to 50 range. No matter what I eat there seems to be no rhyme or reason to it. Exercising is a real trick too. Most days I feel horrible. I was on no carbs for the first six months after surgery, then reintroducing them was hard. I was sick on them often but am now tollerating them, which of course makes me scared also. ANY form of carbs make my sugars go bonkers. But then when I do all protein my sugars are constantly low. Never about 60. So, I'm really at loss. This doctor wants to do some further panels but said with the ones they've already done, I am in the beginning stages of diabetes. HOW can this be? I was never diagosed with diabetes prior to my surgery, LOST 100 lbs. and NOW I have diabetes???? It's so hard to believe....if there is anyone out there facing a similar situation that has found answers please email me. Thanks! Laurie Beggin

Laurie, I'm sorry to hear about your diabetes....hopefully the Endo will get you on track in a few months and you're able to treat your low blood sugars with glucose tabs. Congratulations on losing the weight and can understand your frustration with gaining weight, having high/lows of blood sugar, and carb confusions. I started doing alot of research due to my serious low blood sugar incidents.....sometimes in the teens and having to call 9-1-1. I take glucose tabs, gel, and in emergencies my endo gave me a glucagon. And wanted to know if the hypoglycemia was somehow related to WLS. I did find interesting articles on hypoglycemia and non-diabetes claiming the pancreas is overstimulated and releasing too much insulin......could that be your case? I doubt it if you we're diagnoised as being diabetic, but you never know....you may want to do a google search, and of course, talk to your dr or endo. Good luck, I hope it gets resolved for you. Links: http://www.nfb.org/vod/vod211/vodwin0608.htm or general info on diabetes: http://www.joslin.org./ Take care, Wendy Type 1 3/15/04 278/188/150

Hi Wendy! Thanks for responding. I completely agree with the idea of me not being diabetic. The new PCP doctor I saw SWEARS that my blood panels indicate that I am. He said I was a 6.5 which is the measure for how much sugar is attached to the red blood cells. I also did a lot of research on the net and was/am convinced that I suffer from hypoglycemia only. I stopped following the advice of my other PCP (which I've since dropped) and am trying with all my might to get off of carbs. You know though, once the beast rears it's ugly head....so I'm working on that. I seem to do better with no sugar and the steady low blood sugars vs. the highs and lows. Those plummets are just horrible to expereince. My LORD you have been in the teens???? Whew. My lowest was 25 and I was sooo sick. I came close to calling but didn't. Later learned that I should have so now I know. I've got a button through ADT security system and I also carry the shot with me at all times. So far I haven't had to use it. How long have you been struggling with this? I got my notice in the mail from the endo confirming my appt. for June 7th. I'm just so frustrated that it takes so long to get in. I'm hoping my PCP can push the issue and I can get in sooner. This endo is very well respected so I want to see her. At any rate, this is a real bear isn't it?? I need to rely on the glucose tablets instead of bread, hard candy, etc. when I get low. It seems that eating that makes my cravings worse. I noticed that with a couple of glucose tablets I didn't have that issue. Should have followed my instincts on that vs. listening to the doctor. Her directions were this... BEFORE I took glucophage she wanted me to eat a big meal loaded with carbs and force my sugar up over 200. (since the glucophage lowers the blood sugar) and THEN take the glucophage to lower it. It makes NO sense to me. I explained this to my new PCP and he agreed that it wasn't going to work with someone that has had GBS and he felt that was what has contributed to my weight gain. Granted, I can't eat a "meal" like a normal person. My pouch at three years out can only hold one slice of bread with a slice of cheese, or one thin piece of pizza, or 1/4 of a bagel, etc. Any bread fills me up fast and I feel yucky. The hard candy is another story...NOT good. Can't eat most sweets like ice cream, no more than a couple of cookies, etc. or I feel very nauseated so I'm lucky with that. BUT, I am SO sensitive to sugar now that the least little bit makes me gain. Ahhhh, the wonderful life of post-ops! I am still happy I had the surgery but I have been frustrated with this issue of sugar/iron problems since last June. It seems it's taking an awful long time to get it ironed out. So, thanks for your support on this. Any tips you can give me or ideas would be appreciated. Laurie B.

I'm so sorry to hear about the diabetes. It's no fun at all. I'm also Type II, I take glucose tablets for low blood sugar - 4 of them. I keep them on my bathroom counter as I'm typically low in the early morning although not so much anymore although I've had at 59 earlier this week. My surgeon recommended them as well and I used to take them presurgery so I was used to them. I get them at Walgreens. Good luck to you sweetie. Regards and hugs, Ronna

Hi Laurie, WOW, you're going thru alot with the PCP and now not getting an appt with the endo for a few more months.......I agree, it takes forever to get an appt. I get very discouraged talking with my endo, seems they only care about the AIC, which mine is 6.4 with my last labs. Doesn't help me with the low blood sugars. I literally have 6 bottles of Glucose I get from Walmart for treating the lows. Please carry them with you at all times, even the liquid glucose and when you feel "strange" take it. Do you have a blood sugar meter? Having either high or low blood sugar affects the brain and organs, so either is NOT good. Like I said, I've been roller coasting with my blood sugars for years, even before WLS, but now that I'm 2 yrs PO, the lows are alot worse. The endo doesn't think its b/c of the WLS, BUT the digestive systems is different and the way we absorb carbs, sugar, etc....is not the same. Having you eat high carb meals is ridiculous in my opinion, BUT I'm not on any meds, just insulin....so I can't tell you much about that aspect. Just be safe with the low blood sugars and remember that ADT is not going to help you when you are disoriented from low blood sugar. Believe me, I looked into the system of "I've fallen and I can't get up" for $30/month, but it wouldn't work knowing when my blood sugar fell to 17, I was so out of it, I don't even remember what happened during the 1/2 hr of time and being so low. Luckily my husband got home at the right time and gave me glucose gel......I was physically and emotional wrecked! I now have a lockbox with my house key for the ambulance dept and it was only $150. The chief had told me, even if I dial 9-1-1 and hang up, they have my information and will help me. I also exchanged my Meditronics pump and have a new Paradigm pump which has helped in reducing the low blood sugars by telling me how much insulin to give myself based on my carb/insulin ratio and correction factor. I'm still not convinced of overestimating insulin is causing all of these lows, but since I'm Type 1 diabetic they don't believe I have this medical problem new to WLS patients involving the hypoglycemia. Please take care and I hope you get this resolved. Please feel free to e-mail me personally morris119 @ yahoo.com Wendy 3/15/02 278/188/150

Thank you to all that have responded to my SOS. I'm still quite upset over not getting faster resolution to this problem...at any rate, it seems that the majority that suffer from the lows tend to do the following (if I understand it correctly) They do take the glucose pills or liquid to manage the low numbers but other than that stick to protein only?? It seems that when I stick to protein only (and I have to admit fats are on my list also) I feel better but stay in the real low ranges. At least then I don't have the swings. So, it's my understanding that if I manage my lows with the glucose, always have it with me, it would be better for me to do that than try and incorporate breads, crackers, etc. in my daily diet and then have to deal with the swings?? I do have a blood monitor. As an example, I ate a double cheese burger from McDonalds (road trip is the ONLY time I eat fast food). I took the top bun off and ate the bottom bun with the two small patties of meat and cheese. My sugar went to 170 but only plummeted to 69, although it did plummet. We were having to take my father to the Mayo Clinic in an emergency situation, I did lots of walking (the place is huge and beautiful!) but I know a couple of days there I didn't get the proper protein intakes. My problem seems to be that I will be feeling absolutely fine and it just SLAMS me, almost instantly, where my heart races, I sweat, and feel very floaty and a bit nauseated. At times I loose my ability to think but have never passed out. This happened when we left the clinic. I was talking to my son on the telephone and whoosh, by the time I got my reading it was 46 and that was after slamming some pure protein followed by four glucose tablets. Within five minutes it was to 58 so I knew it was coming back up. I just feel so incredibly SICK after I have a low like that. So, does it seem that if I do the glucose only and otherwise stick to protein (I'm sure it's suppose its suppose to be lean proteins and not cheese which I live on?) Lord, I just don't know where to turn and the doctors are taking the sweet, sweet time with helping me...I call, I try different doctors, but am getting no definitive plan of treatment. I'm seriously considering going to Mayo Clini****il they can figure out what is going on with me. Low low iron counts, lupus, fibomyagia, constant pain, inability to exercise and now the low and or plummeting sugar counts....I'm seriously bummed. Not to mention the 30 lbs weight gain. I wrote earlier that it was 25. Well now it's 30. All in ONE year. I maintained the 140 weight for two years....so I really believe it's something with my health that is triggering this. Also, no menstration so far this month so I am clearing entering into perimenapuals....any ideas, or similar experience out there, please share! Thank you WENDY for all of your support and kindness. I do carry the glucose tablets with me along with hard candy but will get the liquid per your suggestion. And yes, I realized too late that the ADT wouldn't be much good if I was not right in my mind. There have been several times when my son has noticed it and told me to take my sugar count and he was right, it was low. My husband seems to be oblivious to it....sad but true. Anyway, thanks everyone! One Frustrated chick on this end@ Laurie B. Yogawoman

HI Laurie, I can tell you're frustrated and who wouldn't be when it seems like the medical field isn't listening to your symptoms. I'm glad that you carry the glucose and will get the gel. Please let your family know that when you seem out of sorts or get sweaty to tell you to take 4-5 glucose. Even if you don't have time to test your blood sugar at first. When you get those symptoms, its typical low. I don't quite understand you eliminating the carbs from you're diet though, you do need them, just in moderation to keep your blood sugar normal. I agree, just protein will not keep your blood sugar up at all. In fact, being Type 1 diabetic, if I just eat protein, I don't need insulin, just carbs. I don't fully understand hypoglecemia, so when your ready to eat a meal and your sugar is within a normal range, you eat something that is high carb/sugar meal, your blood sugar crashes an hour or so later? I think if you can't get your PCP or endo to correct this problem until June, maybe make an appt with a nutritionist or diabetes educator, one that understands gastric bypass. Maybe an area hopsital can help you find someone in your area. I go to one who attends our support groups, and she has be on a 1,500-1,800 calorie diet, 35 grams of carbs per meal, and I'm trying to stick to the 120 grams of protein/day......which I supplement with protein shakes. I hope you get your iron levels up, if you can't get B-12 shots thru your PCP, any vitamin shop carries sublinguials.....which I take about 2,500 mcg per day. Its very important to keep that number on the higher end of the labs. Please e-mail, if I can help..........take care Wendy

Laurie, I wish you well in getting some answers. I don't think you are diabetic--you are hypoglycemic. I have been taking insulin for 24 years and 11 years of that on an insulin pump. Your A1c number is slightly high but that is because of what your PCP was doing to you by giving you oral meds to lower your sugar and tell you to eat a high carb meal. That is like shooting yourself in the foot. I have lost 100 lbs while taking insulin but the short bowel problem of gastric bypass literally dumps food into small intestine where is raises your blood sugar extremely quickly. I can't have more than 30 grams of carb without my sugar going over 200 rather quickly. I don't eat bread or pasta often at all. I get slow carbs from beans, brown rice, potatoes in stew with meats, starchy vegies like corn and peas or fresh fruits like berries, mellon, oranges, apples. I try to go for low glycemic foods. I think you need some slow, long burning fuel like complex carbs and protein together and healthy fats like olive oil and nuts. Hopefully the endocrinologist can work with you to get a quick resolution to the dangerously low sugars. Theresa

Hi Laurie, I just meet with a leading Endocronologist at one of the nationsMAJOR Diabetic research centers. As it also happen this MD is also an expert on Obesity..... He told me that he is seeing AN INCREASE IN FOLKS POST GASTRIC BYPASS DEVELOPING DIABETIES.... Since my bypass 2 years ago... My BGL levels are in better control ........... BUT AS A RESULT OF Sudden and DRASTIC changes in them.. I have developed a serious complicatin of Macula edema and retionpothy...... It seems that the drastic changes can cause complications as easily as having too high BGLs. In an otner week I will have a 3rd Laser surgery to try to reduce the macula in one eye. HOWEVER the loss of vision that has occourred over the past year is permenat. Please make sure you get a dialted eye exam and make sure your eye MD knows of any changes in your vision ASAP. ESP any central blurrines, as well as seing stright lines as wavy. I have had eye exams every year and these changes happened very quickly. I am sorry you are having these problems. My MD said he is seeing these types of problems on folks like us...2-4 years out! PLEASE make sure you follow up with your MD. Dealing with Diabeties can be a hasel in the beggining but once you learn about it and what your body's need are then it does get more managable. Hang in ther Lisa. PS: To avoid the mid night low's I always have 1/2 an english muffin with PB. ALOS keep some apple sauce in the fridge.. ALSO contact your local hospital and ask if they have diabeties education classes.