Question:
How do I handle hypoglycemia & protein issues??? Please Help!!!

I am one year post-op and have lost 73 lbs. I still need to lose 23 more lbs. but I was diagnosed with having hypoglycemia. Now my problem is trying to focus on protein to lose the 23 lbs. but not getting enough carbs to maintain my sugar levels. Therefore I get shakey, etc. My blood sugar dropped to a dangerous 36 one day. How on earth can I deal with trying to lose this additional weight, keep it off and deal with hypoglycemia? My doctor even said it's more like "reactive hypoglycemia". I've read books, etc. but none of them deal with gastric bypass patients and hypoglycemia. Any thoughts, suggestions or personal experience would be most appreciated!    — Robin L. (posted on September 9, 2003)

September 9, 2003
All carbs are not created equal. Stick w/ whole grain carbs like 100% whole grain crackers (some of the rye crisp and wasa varieties) and 100% whole wheat bread. Eat this with a protein like a piece of cheese or some peanut butter. Eat veggies. These won't cause the insulin spike and crash. Stay away from REFINED carbs.. anything w/ white sugar or white flour. Make sure you ALWAYS include a protein if you're having a carb, even a healthy whole grain one. Eat smaller meals throughout the day so you don't go too long without food.
   — mom2jtx3

September 9, 2003
Being a former diabetic (I just love being able to say "former"), one thing that might help is to eat more often. If you keep a steady supply of "good" carbs (as suggested by the previous poster) and protein going in, you are more likely to maintain a more even blood sugar level. Try eating very small meals every couple of hours. You can still control the calories, just spread them out throughout the day.
   — Vespa R.

September 9, 2003
I also have reactive hypoglycemia as a result of surgery. I know the best way for me to keep my blood sugar levels at a somewhat normal keel, I need to avoid supper sugary foods. Even a small fruit and yogurt parfait from McDonals will make my sugar drop. I can counter balance a drop by eating an apple, but I do try to avoid them when possible. Before I knew I had hypoglycemia for sure, I thought I was just having strong sugar cravings and would shove sweets into my face until I dumped. Now, a year later (I'm 2yrs+ post) I have a much better grip on the situation. I know to slow myself down, eat a fruit or a few pieces hard candy, and give it a few minutes and I'll be fine. I pretty much eat all day long too...seriously. But, I (try to)limit my foods to low fat/low sugar, good carbs or high protein, and around 100-200 cal. a shot. I still need to work on getting more fiber though...I probably eat 2-3 pcs fruit a day but can go a few days with nothing more than a few slices of tomato as a veggie choice. I still can have really bad days though, believe me, it's a constant strive to make this work (surgery) that's helped me keep the weight off, despite going off the deep end a few times with food. I've shifted my goals from loosing weight to feeling good. Probably a good move. I'm rambling now, best wishes. -Kim open RNY 7/17/01 282/138ish/125
   — KimBo36

September 9, 2003
I also have problems with hypoglycemia. I find the best thing is high-protein mini-meals. I rarely go more than 3 hours without eating. Hypoglycemia hits me the worst about 2 hours after I eat a high-carb meal. It takes me the rest of the day to recover from it. Cereal and milk is a BIG no-no for me. I don't dump, but BOY do I regret having it a couple hours later! I did myself in on Saturday by walking up to my health-food supermarket (about 2 1/2 miles from home). I was going to have one of their hot entrees for lunch, but there was so much good stuff out to sample that I didn't feel I needed anything else. I THOUGHT I had eaten enough cheese to balance the fruit and bread but NO! I had an attack of hypoglycemia about 2/3 of the way home. The rest of the walk was torture! I don't think I would have made it if I hadn't bought some plums. They boosted my blood sugar enough to keep me from sitting on the side of the road.<p>I think the best rule is eat often and eat protein. Once you're sure you've had enough protein, eat some fruits & veggies, then other stuff if you have room. Try to stick to whole-grain and other unrefined carbs whenever possible. That will keep your blood sugar from yo-yoing all over the place. I feel for ya cuz I know from experience it is NOT much fun!
   — ctyst

September 9, 2003
Reactive hypoglycemia seems to be pretty common for us post-op. It IS just flip side of the physical portion of our disease (insulin resitance). Most of us get our protein via shakes (made with water), and try to space the meals close enough to prevent holes. But there are no guarantees. I've included the link to the Grad list so that you can speak to others who have this problem and how we all deal with it. http://groups.yahoo.com/group/Graduate-OSSG
   — vitalady

September 9, 2003
Robin, I'm 10 months out and they just found out that I have hypoglycemia too. The lowest it has dropped is 20. YIKES!! I dump on anything over 10g's of sugar so I have to eat carbs to get it up. The best way I've found so far is to eat every 3 hours. I have a mix of carbs and protein. I eat fresh fruit only (not canned or frozen) at least twice a day. Peanut butter on saltines (they have fewer carbs than most other crackers) or nuts. I also snack on beef jerky and that new chedder and bacon cheese. I HAVE to eat something just before bed becasue my fasting blood sugar is the worst so I eat a spoon full of plain peanut butter. Most days my blood sugar hangs in around the 70's which is in normal range. My weight loss has picked up (maybe I needed the extra calories?) so I know this system works for me. I have 13 more pounds to go but I know I'll get there even with the extra carbs. Good luck and I hope you find what works for you. ~Sidney~ Open RNY 10-23-02 down 115+ and counting
   — Siddy I.

September 9, 2003
I was told when I had hypoglycemia problems to eat more protein and cut the carbs and so far it's worked for me.
   — Cathy S.

September 9, 2003
Robin, thank you so much for posting this question! Recently, I too, have been experiencing low blood sugar. I'm so close to my goal weight, so I decided to "do Atkins" and since then have been having this problem.I have been thinking that if I ate smaller meals more often, this might help, but then it brings up the problems of 1) what really is a small meal? and 2) how do I get in my 64 oz of water if I have to wait 90 minutes (time my Dr. suggests) after eating? Hopefully others will be able to help us.
   — Kim B.

September 9, 2003
Go see a nutritionist. They are highly qualified to make you a specific diet tailored to your needs that will help you to lose weight and maintain healthy insulin levels. I have the same issues and rely heavily on my nutritionist. I am now starting to up my carbs just a bit from 30 gr per day to 75 because of the whole sugar thing and how it effacts my energy levels and because I want to be a little more active. It takes careful planning and dilligence but it can definitely be done. Trust a pro who you can check in with every week and be safe.
   — Carol S.

September 9, 2003
I am hypoglycemic, and was pre-op as well - it's just worse post-op. Fortunately, I knew what it was and how to deal with it (and also had the nutritionist helping me figure out how to deal with it - especially during the pureed food stage). Here's what works for me: Never going more than a few hours without eating SOMETHING - that something preferably being protein or COMPLEX carb (whole wheat bread, brown rice, nuts, etc.). NitroTech Protein bars - these have only 3 new impact carbs (rough translation - the carbs they have don't have a derogatory effect on insulin/blood sugar). I have a half a bar in the morning and a half a bar in the afternoon. Always have SOMETHING available for an "emergency" - a little bag of trailmix is good - I carry this in my car. It keeps well, it's full of good carbs, and a small handful literally turns it around for me. I am not lactose intolerant, and milk works well for me too - good protein plus the boost in sugar. What doesn't work? Simple carbs - white breads, crackers, that sort of stuff. Yep, they'll give me a jolt, but it's not a stable situation - very roller-coaster blood sugar, which isn't good, either. A little planning can help keep your blood sugar on an even keel - and keep you standing up instead of falling over, ha, ha. Good luck!
   — johanniter

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