Low Sugar Levels

I am 9 months post-op, 140 pounds down from my highest weight. Lately (the past 2 weeks) it seems no matter what I eat or drink (protien, veggies, orange juice, fruit, etc) my sugar level plummets.. For instance, my level after dinner last night was 141(which is normal after eating. My Doctor said up to 180 is), and 3 hours later it dropped to 41 (that was one experience I would rather never go through again.) So I drank some o.j. and had a tablespoon of peanut butter. It raised to 86 and I went to bed. I woke up this morning, and it was at 56... I see my Doctor tomorrow, but am very curious as to why this is?? I was on insulin because of type 2 diabetes before surgery, but have been medication free as my levels have been perfect since, until now.. Opinions as to what may be going on?

Put Reactive Hypoglycaemia into the search function and you will get lots of useful information.   What you are experiencing is usually very easily controlled by following a strict RNY diet ...

Orange juice really has no value in our lives and is one of the worst things to drink because of RH!   

This condition is very common among our community and usually starts to occur when we start adding in foods that are high sugar/high carb (like high sugar fruits and orange juice - which to all intents and purposes is liquid sugar!)  

 Thank you for the response! That makes a lot of sense. I usually only have the orange juice when it gets that low to bring it up (what I did pre-surgery). The fruits however... I never actually thought about that. It's funny, before my surgery I never ate fruit. Candy, Chocolates, etc I did. After surgery, when I have been craving sweets, I turned to fruit (dietician packet states fruits are OK to have) thinking at least it is healthier than what I used to do. I will do as you suggested and research. Time to change some of my diet. Thank you again!

I agree as it does sound like Reactive Hypoglycemia...I was pre-diabetic before surgery and also came off my meds upon leaving the hospital. I experienced a drop in sugars and bought a monitor to keep an eye on it. Through diet I seem to have kept things relatively steady by eating smaller meals more frequently, heavy in protein and complex type carbs in small amounts (I'm 8 months out at the moment). Still every now and then I feel light headed and dizzy, especially upon waking early in the morning and I go for a protein shake (which I don't have that often anymore) to get some protein in quickly and that helps a lot. Do make sure you get labs checked though with your doctor to make sure nothing else might be going on though...

Thanks! Can you give me a sample of the small frequent meals you eat? I eat 3 small meals (1/2 to 1 cup each meal depending on density) a day. Lean proteins, veggies, sometimes fruit, and very rarely carbs. If I break it up to 6 times a day, every three hours, smaller meals than I already am doing, how do I break that up? 

Hi, my day lately looks a bit like this:

7am (wake up, breakfast): 2 string cheese or 1 hard boiled egg, etc.

10am (snack): 1 oz. almonds, or a 0% Fage plain Greek Yogurt

1pm: (lunch): 1/2 cup chili, or lentil soup, etc. (it's freezing here so I'm all about soup lol)

4pm (snack): 2 tbsp hummus with a few carrots

7pm (dinner): Quest protein bar, or another soup, or a salad with chicken/shrimp on it (which I eat the protein first, then fill up with the veggies after) etc.

So basically I'm doing what you are doing, but I put in the small protein snacks in between and it makes all the difference (for me anyway). Good luck!

Unfortunately, part of the problem may be not eating enough carbs. (Keep in mind that carbs are in fruit, veggies, dairy products, beans, etc... NOT just a separate category containing breads, pastas, rice, cake/cookies, chips, pretzels, etc.

Having meals with a combination of protein, carbs, and a little fat is usually the key to managing RH (or even regular hypoglycemia).   Because of that, cheese is an excellent component of a meal (or snack) because it has protein, carbs, and fat.

You should also talk with our surgeon about modifying the "only three meals per day" eating plan.  Most people with RH or regular hypoglycemia find that their blood sugar stays MUCH more stable when they eat 6-7 smaller meals throughout the day (including, for many of us, one right before bed to avoid the low blood sugar upon waking on the morning).  The trick is that you need to consume the same number of calories in twice as many meals, so portion control is important.

Lora