Low Blood Sugar after WLS

Hey Guys,  I attended my Pre-Op Class yesterday and asked this question of the nurse giving the instruction and I got no proper answer.  I know about the 150 rule concerning the taking of diabetes meds after surgery. But if your blood sugars go low and you need to raise them quickly, what do you take?  I normally would take Glucose tablets or OJ. But I believe either of these could cause dumping. Anybody have any ideas? I've got some time to figure this out surgery isn't until the 16th of July. Thanks, Dan S.......

Dan, Most can deal with "hard Candy" as a source of sugar that doesn't empty too quickly into the guts, but does alleviate the Blood Sugar drop...

From the Obesity Surgery text book by Louis Martin page 221: "some patients developed episodes of symptomatic hypoglycemia with documented levels of plasma glucose of 40 mg/dL or lower and associated acute lethargy. These episodes were unpredictable in onset, occurring as late as 14 years after the gastric bypass…." "The hypoglycemia was not related to whether or not they had diabetes prior to the surgery. In all of the patients, the symptoms lasted no longer than 2 years and were managed reasonably well by encouraging ingestion of one or more pieces of hard candy until lethargy resolved." Obesity Surgery by- Louis F. Martin ( a textbook of Bariatric Procedure) A pre-view of the book (some extensive excepts) are available online at- http://books.google.com/books?id=LUcPAYbgNe0C&dq=louis+marti n+obesity+surgery&printsec=frontcover&source=web&ots=otxJnXu eKh&sig=S1gEgyy2YsB10RRE1mKHDHVC1k8#PPP1,M1  and- A Complete Guide to Obesity Surgery: Everything You Need to Know About Weight Loss Surgery and How to Succeed Bryan G. Woodward

Is the "for patients" version and much less dense….Many libraries carry it too. My library has it. Just what I had on hand…. Hope it helps. Best Wishes- Dx

HI Dan, I think you will be amazed at how fast you will not need the meds and the surgeon will tell you not to take them  Right after surgery (while in the hospital) they gave me insulin.  Within 5 weeks I was off all of my diabetes meds.  My 6 month checkup and my non-fasting blood sugar was 82.  I was shocked.  Before WLS, I would start shaking if it dropped below 110.   Dx is right, hard candy should be fine for you, but my guess is you will not need it very much at all because the doc will take you off the meds.  I was taken off Glucophage right after surgery, then Avandia at 5 weeks. All the best with your upcoming surgery.

Thanks Guys,  I knew if I asked at the right place I would get a proper answer. Hard Candy it is then.  It will be great if I can fully get off of my diabetes meds. Between the 2 types of insulin and the 2 oral meds not to mention syringes and pen needles, oh and don't forget the alcohol swabs and sharps containers. I'll be able to save a bundle at the pharmacy. Dan S.....

A big thumbnail of my experiences. Following surgery, my quack^H^H^H^H^HPCP would not let me drop the Actos I was taking, even though I was much more controlled, and it was causing me problems. In the end, my low sugar problems ended when I flipped him off and quit taking the stuff anyway. There is often a period after surgery where even those who are not taking meds experience blood sugar problems, so this post is not aimed at just you. When someone experiences low sugar, you must eat something. There's a range of foods to eat, and they respond differently. Pure carbs will bring you out of the low sugar the fastest. That's their advantage. The disadvantage is that the reaction is so fast, you can have an echo crash 2-3 hours later, and you can get a vicious cycle of crash-carb-crash-carb going. At the other extreme, a pure protein will not cause an echo crash, but you come out of the present one very slowly. If your sugar is very low, this could be dangerous. My personal solution was to keep prepackaged cheese crackers handy at all times. Enough carb to bring you around, and enough protein to buffer the reaction and keep you from echoing. Lance even had cheddar on whole wheat crackers, which were my favorites. Peanut butter creacker work too, but I despise PB...

Thanks Bob,  Something else to keep on hand just in case.  It's good to have alternatives. Hopefully I won't need them.  I would like to be prepared if the condition should occur. Dan S......