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low blood sugar post RNY



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I had RNY in 2003....have had very slow weight loss even tho I've followed prescribed diet, routines. I developed postprandial hyper insulinism (low blood sugar after eating a small amount of carbs (5-10 carbs) This has been life threatening. I experienced insulin coma several times before it was diagnosed. Endocrinologists tell me they are seeing more post RNY patients with this very serious problem. If you become sleepy and confused then "fall asleep" 90 minutes to 2 hrs after eating any carbs I urge you to get a glucose monitor and check your blood sugar when you start to feel tired or confused. My blood sugar has been as low as 28 after a doctor had me eat a bagel so that he could " see it happen." He had not believed me but after that he understood what I was talking about. I take acarbose if I know I will eat 10 or more carbs ( 1/2 a slice of bread!) and it does help. Doctors who have not seen this may be skeptical so get a glucometer at the drug store and check your own blood sugar. I can fast for 24 hrs and have normal blood sugar...But eating carbs will put me in a crisis state immediately.

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The condition you are experiencing is called reactive hypoglycemia. A few patients after gastric bypass surgery experience this condition. Reactive hypoglycemia (postprandial hypoglycemia) refers to low blood sugar that occurs after a meal — usually within four hours after eating. Signs and symptoms of reactive hypoglycemia may include hunger, weakness, shakiness, sleepiness, sweating, lightheadedness and anxiety.

These links discuss the condition:

https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass

http://spectrum.diabetesjournals.org/content/25/4/217 [Most patients with dumping respond to nutrition modification, comprising frequent, small, low-carbohydrate meals. In this article reactive hypoglycemia is referred to late dumping syndrome.]

http://www.weightlosssurgery.ca/before-after-surgery/reactive-hypoglycaemia-post-gastric-bypass/

https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

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I've had this happen to me a few times. Once, I literally passed out and woke up about 2 hrs later. Shoved in some sugar and was fine in a bit. NOTHING to the extent you have. I do see some sequela with long term RNY (2003 also), but I'd change nothing. Still glad I did it. Just adapting as need be. Hope you're better.

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    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

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      · 1 reply
      1. NickelChip

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      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

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      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
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