Hypoglycemia After Weight Loss Surgery
September 9, 2015Hypoglycemia is a term used to describe low blood sugar levels. Hypoglycemia is low blood sugar that typically occurs when meals are skipped, delayed or contain too much sugar or too many easy to digest carbohydrates. Preventing a low blood sugar is always preferable to trying to manage and treat.
Some research shows that greater than 18% of gastric bypass patients (1) can develop hypoglycemia one to two years after surgery. What is even more alarming is that the majority of people who have low blood sugar may not be aware of it. Hypoglycemia may lead to confusion, loss of consciousness or seizures. There is always the fear that someone is more prone to an accident as a result of having a low blood sugar episode.
Researchers are just starting to conduct studies in the hope of being able to predict and prevent these episodes which can be debilitating. In general, there is a higher prevalence of hypoglycemia with gastric bypass; contributing factors include greater weight loss and lower insulin resistance.
A drop in blood sugar can be dangerous if it goes too low without treatment. Tell your doctor if you start developing any of the symptoms below.
Mild-Moderate Hypoglycemia (blood glucose between 40-75 mg/dL)
• Increased or sudden hunger
• Feeling shaky, dizzy or nervous
• Pounding heartbeat
• Sweating
• Numbness or tingling
• Headache, nausea or anxiety
• Difficulty concentrating
Take corrective action immediately if you experience mild-moderate hypoglycemia
1. Check your blood sugar using a blood sugar meter, if you have one.
2. Treat with glucose tablets.
3. Take two to three tablets and check your blood sugar after 15 minutes. The level should increase to greater than 90.
4. If you don’t have glucose tablets, drink ½ cup of juice or eat a small amount of candy. Limit yourself to a small amount, 15 g of carbohydrate or less.
Remember that too much sugar can contribute to dropping your blood sugar level again. After the glucose tablet treatment, eat a small snack. Try 1 Tablespoon of nuts and a slice of fruit, or 1 slice of cheese and 2 whole grain crackers or a Greek yogurt.
Check your blood sugar often with a meter. Checking blood sugar will help manage hypoglycemia and can show trends in blood sugar levels.
Minimize intake of carbohydrates as much as possible. There is variability among individuals so checking a blood sugar one hour after a meal will provide the best information. If low blood sugars happen frequently, and without symptoms, a continuous blood sugar monitoring device can be instrumental in providing individuals with information regarding the direction and speed of blood sugar changes. Dexcom is a commonly used device. Some people may need to see an Endocrinologist.
Long-Term Prevention of Hypoglycemia
- Eat small, frequent meals throughout the day. Eating 5-6 times, every 2-3 hours can keep blood sugar levels stable.
- Don’t skip or delay eating times. Follow your schedule. Always eat a protein and carbohydrate combination.
- Choose carbs that are lower glycemic. Low glycemic carb foods they digest slowly which adds stability to the blood sugar. These foods often have higher levels of fiber and can also have higher levels of protein. For example, avoid white rice and opt for brown rice or quinoa instead.
- Choose chickpeas, lentils or black beans instead of potatoes.
- Consider peanuts instead of pretzels as a snack. It is better to eat a protein or have a protein and vegetable combination rather than a carbohydrate food by itself.
- Remember single digits in sugar when looking at the food label.
- Avoid foods that contain sugar such as: cakes, cookies, candy and pies, ice cream, puddings, soda, sweet beverages, sweet tea and juice.
- Keep a food log and track your blood sugar readings along with any symptoms you are experiencing.
- See your dietitian who can help you with a meal plan.
We will keep you posted on the results of new research as it becomes available.
Hypoglycemia IS manageable and preventable!
References:
(1) Predictors of Hypoglycemia in Morbidly Obese Patients after Bariatric Surgery, JOHANNA MARIA BRIX, HANS PETER KOPP, GERIT HOLGER SCHERNTHANER, GUNTRAM SCHERNTHANER
Photo credit: sriram bala
 | ABOUT THE AUTHOR Ellen Michal, RD, LDN, CDE has been a Registered Dietitian for Duke Raleigh Hospital for 15 years. Ellen's areas of practice include Weight Loss and Metabolic Surgery, Diabetes Education, Lifestyle Management and Kidney Disease. The most positive aspect of Ellen's job is seeing people transform their body and mind after surgery.Read more articles from Ellen Michal! |
