Reactive Hypoglycemia?


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So, last night I was tired and went to bed early. I woke up about 3am to use the restroom and passed out while standing at the toilet... Bashed my face into the throne and then passed out again a couple minutes later while washing my hands.

I was still feeling off this morning and went to the ER. I had eaten a Fiber one Protein Bar and Greek yogurt before deciding to go in. They ran a few tests and have me fluids... My blood sugar was only 60 even after eating.

I've never passed out or had problems with low blood sugar before. I had steak and baked potato for dinner and a pear for a snack before heading off to bed. Could the sugar in the pear have sent me into a hypoglycemic crash?

Anyone have any experience with this 8 months after RNY surgery? From what I've read this seems like a problem people run into later after surgery (18-24 months) and usually from eating sugary foods.

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I know only what I've read -- this condition afflicts some RNY patients (as I recall, it was in the double digit percent of patients) and also to some but fewer sleeved patients (single digit percent). I don't recall the numbers - sorry.

As I recall, when it appears, it seems to be a major pain in the ass and is addressed to some extent by eating certain food combinations throughout the day -- not at the "grazing" level, but just strategic snacking.

I've read several research studies on this condition. Here are a couple I remember finding earlier:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190577/

http://spectrum.diabetesjournals.org/content/25/4/217.full

That's all I got.

P.S. Of course, this may NOT be reactive hypoglycemia, but something else, including some kind of bug. But I knowyou'll let an M.D. diagnose what's going on with you. Best wishes.

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I hope you are okay - falling in the bathroom is so dangerous!

Thank you - I'm okay. Definitely scary since I really had no warning... I didn't feel shaky, dizzy, etc. The doc at the ER told me to be extra diligent if I'm driving, near Water, up high, etc until I get this figured out completely because the consequences of passing out are really high in those situations. I'll be seeing my bariatric team ASAP next week.

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Here is a short article on reactive hypoglycemia (RH) after gastric bypass surgery. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/

The individual that I know who had this problem did not have diabetes prior to surgery. I believe the first time he encountered the condition he fainted. But ever since then he learned to detect the signs and took immediate steps to preclude the onset. So after the first incident, he never repeated it.

It seems that RH occurs between 1 1/2 to 3 hours after a meal. Since you woke up at 3 A.M. this might not be RH. Since your blood sugar when you had it check the next day was 60, that is on the low side. So the condition might be related to low blood sugar (hypoglycemia) or something else.

Another possibility is orthostatic or postural hypotension. Here is a link to that condition. http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/symptoms-of-heart-and-blood-vessel-disorders/dizziness-or-light-headedness-when-standing-up

This is one of those problems that you will need to discuss with your medical professionals.

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I would think if it was a hypoglycemic reaction that you would have had symptoms prior to fainting. I hope they figure out what's going on and it's easily treated.

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Typically with reactive hypoglycemia, or even hypoglycemia for that matter, you would feel very shaky, racing heartbeat, you may be sweaty, and nauseous all before passing out. Typically you do not just faint. That could be blood pressure. But also I would think you would feel dizzy or lightheaded from low blood pressure. I hope whatever is going on you find out what is going on and it is dealt with.

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So I am one of the unlucky ones who gets reactive hypoglycemia. It is not fun and I am still trying to figure out the combination of foods that cause if for me.

I have had it happen about 12 times since surgery 20 months ago. When it comes on, you don't even realize it is happening until it is almost too late.

I suddenly don't feel right, I start shaking and I crash very fast. It takes a lot to get my sugars back to normal. I was a very controlled diabetic before surgery.

I will usually have a Protein shake for break fast but occasionally I like a small bowl of cream of wheat. On the days I have that cream of wheat I have to be very careful eating some Protein within an hour of the cream of wheat. If I don't do that I am almost guaranteed a episode. Once you have an episode it is very difficult to get control of it without eating more carbs all day long so the trick is never getting there in the first place.

I had an episode last week and looking back at why, I know my carbs were higher than normal and my body simply does not like that.

It is a very scary condition and if it gets too severe and you don't figure out what causes it, the only cure is having your bypass reversed which is absolutely not a solution for me. So, I have to be diligent about eating right and checking your sugar the minute you feel weird.

Last week when I felt it I tested my sugar and I was at 43. Scary!

I hope you figure out what might be causing your situation. Make sure you get to the bottom of it so you don't break your face!

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I've tested my sugar quite a few times over the past two days. It looks like my sugar runs on the low side most of the time and was 89 this morning when I woke up which is pretty consistent with my lab work whenever I'm fasting.

I don't really see any trends so far comparing the sugar level to when I eat... often it seems like eating has no effect on my levels at all. I'm using My Fitness Pal to track my food again - but I don't know if it gets specific enough on the time that I'm eating to really be of benefit... might have to go with a paper log until I get this figured out.

BS Readings

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Just remember that when you have a meal that is mostly carb without any Protein, you will need to keep vigilant on your blood sugars for the next couple of hours. I used to go hypoglycemic without any warning. Before I knew it I'd be in the 40's. It takes 15-20 minutes when trying to correct before your body will react. Try not to overdo it with the food trying to raise blood sugar. You should always keep some type of glucose tabs, glucose gel, or glucose drink at hand to help raise you back up.

Djmohr, I know exactly that feeling you are talking about. A low blood sugar is very scary. Again, I'd get them with no warning. Hasn't happened in a long time, hence the need for WLS (diabetes was getting too hard to control on an insulin pump). My numbers are much better since surgery, and hopefully with weight loss there will be less insulin resistance and I will continue to improve.

Axlr8n, 89 is a beautiful number for morning. Just keep your eye on it during the day and into the evening too.

Good Luck.

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