Low Blood Sugar

Hello: I have not been on in quite a while. I am 4.5 years out and am having increased low blood sugar issues. I had issues before my bypass for years if I ate carbs alone. Once I had the surgery it disappeared for a while but came back if I say, had a bagel or refined carbs on an empty stomach. After about an hour I would get the shakes so what I would do is eat some protein before or after to balance out. Lately though I have been having increased symptoms and at times when I am eating more balanced meals too. I read on line that this can happen to bypass patients due to the stomach emptying too quickly, which mine does.

Has anyone had these same issues and how do you treat them?  IThanks! Maryann

If you haven't already, please call your PCP.....  Hoping you get it under control and stay healthy! Hugs!

I started having this same problem after surgery.  My PCP did a Glucose Tolerance Test and diagnosed me with Reactive Hypoglycemia.  I can eat a perfectly balanced meal with little or no carbs and my sugar will drop as low as 23 at times about 45 minutes later. Doc and Dietitian told me to eat 6-8 small meals a day and to only eat complex carbs if I eat them at all and not to drink with my meals at all.  This seems to keep things under control most of the time but I still have an occasional day where my sugar will drop. Hope this helps.

Thanks. I am curently keeping a food log with my naturopathic doc and doing blood testing all this week. 6-8 small meals is against what we are supposed to do for pouch rules. Are you gaining weight? Do you have a hard time fitting in your water?  How far out are you from surgery? When you eat this way how is your energy? Good luck to you too!

I am 20 months post-op and not gaining weight.  In fact have been trying to stabilize.  Started at 458 and am currently 216.  The surgeon who did my RNY had already told me to eat six small meals a day to stabilize my weight.  In my case I have to eat a little more.  Tells all of his patients to up their number of meals when they reach their goal weight.  The meals I eat are small and high in protein.  I have never had a problem getting my fluids in.  When I had my last bloodwork done the doc said I was actually a little wet or overhydrated which he said was good.  I often drink over 200 ounces of water a day with no problem. As far as the energy goes I seem to have more now that ever.

OMG!  How do you manage 200 oz a day, esp with 6 small meals?!  Do you drink with meals or do you wait a certain time afer. I try to wait 2 hours but that seems hard if you are eating 6 meals a day. My energy was great until the past year or so when the blood sugar seemed to be getting worse. Hopefully I can get it back again. Good luck with everything and keep me posted.

I start drinking first thing in the morning and drink pretty much all day.  I wait 30-45 minutes after eating to drink per my doc's orders.  I have never had a problem getting my fluids in though.  Is nothing for me to drink 40 ounces or more in an hour at times.

I have "The Pouch Rules"  for Bypass Surgery (given by my surgeon) and it says 3 meals w/ no snacking but with this I definately feel my body drop off after a while if I dont eat. However, I dont want to gain weight. "THe rules also say not to drink liquid for 2-3 hours after meals, which makes it hard to get all my water in if I were to eating 4+ meals a day. I also have read that the fast emptying of our stomachs is a big part of what leads to the hypoglycemia, and drinking with or too close to meals is a factor. I dont remember if it was when I was 12 mo or two years out that I got the pouch rules but they pretty much want you to not drink and then water load increasingly until 15 min before you eat.

I always tell people to follow their doc'c orders.  In my case my surgeon said at his pre-surgery seminar that we would need to eat three 2 oz meals after surgery but that once we reached our goal weight he wanted us eating 4-6 times a day to maintain our weight and not lose too much. In fact he wanted me to go to four meals a day just two weeks after surgery because I was losing quicker than he wanted (lost 28 in the first 11 days).  Once I reached my goal he told me to up that to 6 meals a day to maintain.  He said I would be more of an expert at maintaining my weight than he would and would have to find the right balance for me. When I developed the Reactive Hypoglycemia he told me to talk with my Internist and a Dietitian.  They both recommended eating every 2-3 hours, staying away from simple carbs, and not drinking with meals.  This seems to work well most of the time and I only have occasional drops now. I am aware of the "Pouch Rules."  They are from Weight Loss Surgery for Dummies.  I may be wrong but I believe they are written for when you are trying to lose weight.  I would suggest talking with your doctor and a Dietitian and seeing what they recommend. Good luck. -Steve

For those on yahoo grads, we figure somewhere between 18-24 months for onset of this. I've never figured out what caused it since I was always looking for SUGAR as a cause.

In the last year, needed to drop 13# quickly, so went to all protein drinks and all protein foods only, no carbs at all. After a few months, I added them back slowly and found out immediately that white carbs, potatoes or breads specifically, would cause me to crash 2-3 hours later. I've tested a few times and even a half small potato will cause a crash!

I'm almost 14 yrs out and never figured out what was causing it! White carbs, for me. So far, small amounts of rice or pasta are not doing it, nor fruit, within reason. While I'd always eaten reasonable "starches" with no wt gain, I can see now that it was still affecting the action of pancreas.

As long as I stick with protein foods or fruit or veggie, have had no lows for months.

And our rule out the door was 4-6 mini meals per day for life! The object being to keep the pouch small for as long as possible, but still have distinct meals vs grazing. So, today I do 4 small meals, some more meal like, some more snack like and I've always done a lot of protein in supplement (180g or more), made in wwater. But the protein drinks didn't hold the blood sugar steady if I bombarded me with white carbs!

Bummer. My two top foods? Bread & potatoes. I will settle for the next batch of basic food group: butter, mayo, chocolate (as in protein, not candy).