Reactive hypogycemia and losing consciousness

Agree, ice cream is the worst! I also react pretty harshly to fruit.

Graham crackers are carby but so is the peanut butter. I react to just pb :)

I have RH.

I run a very low average blood glucose (fast avg. is under 65, post-prandial at 2 hours is under 80) with an A1c in the 4.8 to 5.1 range. Therefore, when I have an RH episode, I often don't even feel it until it's under 40, which is dangerous.

This is likely due to years (almost 10) as an insulin dependent diabetic. Hypoglycemia is often the pre-cursor to diabetes in obese people, ironically -- so I was probably hypo a lot years before I rolled into Type II.

After losing over 200 pounds, I have maintained remission status with diabetes with extremely tight control on my carb intake. As long as I do this, I have NO issues.

RH, for me, is always caused by doing something I shouldn't -- and keep in mind that I would never ever eat a graham cracker. That would be asking for an attack. Additionally, peanut butter, despite the inaccurate P/R for being a good protein source, is really just concentrated calories, crappy fats, and salt. My last episode was the result of eating some fresh pineapple -- a rarity -- but I felt good and it was fresh from friend from Hawaii. I should have measured it out and eaten something high in protein with it, but instead, I ate about 1/2 cup by itself. Another time it was caused by eating a dish at a party that I hadn't realized the meat was dry rubbed with a sugar rub. Anything that causes a rapid rise in blood sugar and thus a flooding of insulin will result in me then falling extremely low (RH). This isn't just miserable -- it's downright dangerous.

For me, eating 95% dense protein & quality fats with small amounts of green/non-starchy vegetables with extremely limited low-carb fruit (raspberries, blackberries, strawberries, tomatoes) -- completely controls the misery of RH episodes.

I hope this helps.

Edited to add: my experiences with RH are exactly how you describe, with the exception that I actually take my blood glucose level and confirm that I am low. I also have a prescribed injector of glucose, and my family knows how to handle a hypo emergency. I've been in the 20's before, and perhaps lower. It isn't something to fool with.

Thank you for taking the time to respond. I am not diabetic so I had not been routinely taking my blood sugar but my boyfriend is type 2 and before my revision I wasn't feeling well one morning at his house and my fasting blood sugar was 70. He didn't think that was right so he checked it again and yep...70. I do have a family history of type 2 but have never had high blood sugar. I always passed the glucose tests during my pregnancies despite having 10 and even 11 pound babies (before 40 weeks). The Drs and nurses couldn't believe I wasn't diabetic but the tests confirmed I was not. I would get hypo type symtpoms from time to time but nothing crazy when I was morbidly obese. I wonder if there is some sort of issue in how my body responds to sugar that makes me more likely to respond a certain way under certain stimulus. I am still getting a handle on this new GI anatomy combined with the fact that I am trying to stabilize my low weight. I think your advice reads sound and I do plan on making wiser choices as I learn more about nutrition etc. I will also be making sure that I keep a glucometer nearby. I was also thinking about getting a medical bracelet anyways for other health issues in case I am alone with my non verbal child. I hope this is one of the cases where an ounce of prevention is worth a pound of cure but I do worry about accidental exposure or potlucks, etc. Does this mean I should bring my own food? How did you learn your tolerance?

70 is a completely NORMAL fasting blood sugar. It will sound low to a Type II, because they are conditioned to be between 85 and 110 fasting, but these are actually HIGH for fasting. They are also taught to be 140 or lower after eating (2 hours) -- but this is also not normal. Those without Type II are almost always under 105 even if they eat a dozen donuts and wa**** down with a bottle of corn syrup.

I would suspect that if you've always gotten hypo symptoms, you were headed towards being a Type II in the future. How lucky that you have prevented that! What a blessing.

It's really rare that an accidental exposure catches me now, and as you adjust your diet and learn what sets you off -- using a glucometer two hours post prandial to see how react to different foods is an amazing tool -- it will become second nature for you, too. For me, it's almost always because I have done something dumb or took a chance and pay for it.

Yes. When I was controlling my diet really well below surgery, my fasting BS was 120 to 130. Now it's in the 60s.

I haven't had accidental exposures to cause RH. I've done stupid things I shouldn't have. Twice in 6 years ive tried ice fream, and paid for it both times. I swear I won't do it again. But I'm probably not that smart.

My lowest was a 28. I make sure that people around me know what to do if I have a low. My secretary, the secretary who sits next to her and one of the attorneys a few offices away from me are "on call." Many of my friends know also. Like you, Kat, I've gotten to the point where I'm asymptomati****il I'm in the low 40's, which is super scary. It is definitely not something to mess around with, and to the OP, I would suggest checking your blood glucose levels when you feel like that to make sure you're dealing with RH.

What is the plan for when your blood sugar gets that low? I just revised to RNY but I should probably discuss this with at least my husband in case I ever experience RH in the future.

Sometimes it's a trial and error what works. What seems to work the best/quickest for me is 1/2 pack of peanut butter sandwich crackers. My surgeon suggested the combo for it's carb/protein/fat/sugar ratio. I have also done the Kind bars.

usually if i overeat simple sugars i know it is going to happen and prepare. last time i had a premier protein bar... it solved the issue... but i did feel like poopy all day...

I carry glucose tabs with me or I eat something with sugar to raise it quickly. I then follow it up with a hit of protein to slow down any low that may result. If I don't I'm on the RH roller coaster for the rest of the day, high, followed by low, followed by high, etc . . . .