reactive low blood sugar problems

I am almost 4 years out from RNY. I have lost around 190 pounds. My diet is good, my water intake is good, I even take my vitamins. Over the last 6 months my blood sugar spikes and then bottoms out if I have anything more than a piece of hard candy. Things I use to eat are no longer tolerated . I watch my diet now very carefully, but if something slips by me I have become very good at recognizing my spiking then plumiting sugar. The biggest problem is that it can take hours for my sugar to stabilize again. I think I have it under control then it will drop again, and in a couple of hours it will do it again. When it falls I eat some jelly beans (not many, 3 or 4) so it will raise my sugar but not put it through the roof, then I will balance it out by eating some protein, usually peanut butter. I have tried eating other protein as well but it does not seem to work either. My question to you is how do you handle this when it happens to you. I did not lose almost 200 pounds to become a diabetic. All information would be greatly appreciated

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Reactive hypoglycemia following a RNY is fairly common, even among those who have never been diabetic. Bariatric surgeons call it "late dumping" but it's RH.

Also there was a recent study published by the NIH about the reoccurrence of diabetes in RNY'ers who are further out...about half of those who experienced remission initially, redeveloped diabetes. http://www.ncbi.nlm.nih.gov/pubmed/23161525

BACKGROUND:

Gastric bypass has profound effects on glycemic control in adults with type 2 diabetes mellitus. The goal of this study was to examine the long-term rates and clinical predictors of diabetes remission and relapse among patients undergoing gastric bypass.

METHODS:

We conducted a retrospective cohort study of adults with uncontrolled or medication-controlled type 2 diabetes who underwent gastric bypass from 1995 to 2008 in three integrated health care delivery systems in the USA. Remission and relapse events were defined by diabetes medication use and clinical laboratory measures of glycemic control. We identified 4,434 adults with uncontrolled or medication-controlled type 2 diabetes who had gastric bypass.

RESULTS:

Overall, 68.2 % (95 % confidence interval [CI], 66 and 70 %) experienced an initial complete diabetes remission within 5 years after surgery. Among these, 35.1 % (95 % CI, 32 and 38 %) redeveloped diabetes within 5 years. The median duration of remission was 8.3 years.

Interesting article. Thank you for the info. I guess I am grateful that there are no bathroom issues that come with it.

Interesting article. Thank you for the info. I guess I am grateful that there are no bathroom issues that come with it.

You're welcome but your last comment is confusing? What are you referring to in this: I guess I am grateful that there are no bathroom issues that come with it.

Jelly beans may be too much instant sugar.  I have a really bad problem with reactive (and fasting) hypoglycemia.  I don't eat any even semi-refined carbs (no whole grain bread, etc).  I basically eat protein and vegetables -- and it's mostly vegetables.  My advice would be, when your blood sugar falls, try some hard candy.  Usually one will do it.  A butterscotch drop or maybe a small Smarties.  A little fruit juice is good, but I freeze small bits in an ice cube tray because a bottle of juice will go bad in the refrigerator by the time I can use it all.  You really need to eliminate all refined carbs from your diet.  No rice, pasta, bread, potatoes, etc.  Lately I've discovered that I cannot even tolerate plain unsweetened non-fat yogurt.  When I first started having this problem, my doctor recommended that I get the sugar boosters they make for diabetics.  WAY TOO MUCH sugar at one time.  It would set me up and an up and down sugar rollercoaster for the rest of the day.  My best plan is to avoid it all.  Yes, it's difficult, but you get used to it after a while.  When you finally get sick of being sick, you learn not to eat the stuff you shouldn't have.

BTW - my endocrinologist tells me there is very little chance that I will become diabetic.  I over-produce insulin.  I just wish I could tap it and share it.

I eliminated starches and simple carbs. Even fruits. I may have some fruits once in a while (once a week - 1/2 serving or low glycemic fruits like berries) but beside that _ i jus****ch what I eat. i will not eat beans, grains, and any food that have sugar or wheat - grains added.  I even avoid jerky meat that was cured with sugar.  It is simply not worth it.

Even proteins (lean, no carbs) may cause my BS to raise and drop. I have to make sure I add some fat to my proteins, even protein shakes.  

I will eat up to 1/2 cup of Greek plain yogurt - but I also always add proteins to it and make sure it is at least 2% fat (full fat is better for me). Adding fat to my diet really helps.
When I eliminated gluten - I noticed that my body can handle more carbs and sugar without crashing.   So no more low carb- high fiber flour tortillas, flat-outs, or any baked goods. That my body do not tolerate very well.

I use unsweet coconut or almond milk for my coffee and to add to my proteins shakes. And if I do something "stupid" it make take me up to 2 days of very clean eating to get my BS back to normal.