This is a question plaguing me since my surgery 2 weeks ago. I am astounded by the attitude I have encountered from the health care professionals regarding how to treat a low.

I have DMII but have been taking insulin for 20 years and on a pump for about 8 of those. After surgery, it took a couple of days before they gave me back control and let me use my pump again. My sugars had been running in the 130s, and I kept taking a couple of units to get it into my goal range of 80-120. Then the next time the nurse checked, I was at 80. Sure, this is in the normal range, but it could still be dropping. I asked the nurse for some apple juice, and she blew me off with "You can't have sugar." End of discussion. No alternative given. All I could do was turn off my basal delivery and hope I didn't continue to drop. I think a more appropriate response would have been, "let's test again in 10 minutes, and then do X if it is still dropping." But she did not give me a clue what "X" would be.

Later when I saw my doctor (a fellow), she also poo-pooed my 80 blood sugar as normal. I had to get through to her "what if it were 60?...Then what would I do?" It seemed like she had never considered this. She had to talk to other doctors and get back to me. Her response was somewhat convoluted, but I took away that I should turn off my pump and adjust down as needed, avoiding lows. The result is that I'm always running high.

Yesterday I saw the head of the department, and told him about the incident in the hospital. He likewise denigrated my concerns and said the nurse did the right thing. I was really ticked.

Concluding that these people know nothing about diabetes, I went back to my pump last night and am managing my blood sugars as I was taught by the diabetes professionals.

I'm wondering if I could use the gel glucose if I have a low. I understand it is absorbed through the mouth and does not need to be swallowed.

 Hi I have a surgery date in Oct. I recently called my Endocrinologist. H advised me to call when I got my date. I am on Metformin, Novolog (meal time insulin), and Lantis`(24 hr ). He wants me to stop the Novolog when on protein drinks, After surgery drop everything. 
When you had surgery did you go off all meds right away? Doesn't make sense to me.

Thanks all

Most people (RNY or no) find a low-carb diet to be key in controlling reactive hypoglycemia. The glucose spike and resulting surge of insulin is usually caused by carbs, not just any food. Many have the misconception that only SUGAR is dangerous, but for most folks with these types of issues, it's essentially any carbs, including whole grains, potatoes, fruits, etc.

I am not sure about RNY but BGLs over 200 after eating is way too high for a non-D or D. Are you eating low GI foods or does that not matter if you have RNY?

What happens in people (without RNY) is that if you eat high GI foods, the carbs are absorbed quickly and the body makes a truck load of insulin to deal with the increase in BGL. Then because there is too much insulin, the BGL crashes after. The treatment for reactive  hypoglycaemia like that is to stick to a low GI diet. Not sure how that works with the RNY bit.

Hope this explanation helps. I HIGHLY doubt they would remove a portion of your pancreas.

Cat.

 let you surgeon/endo know know... it could be postprandial hypoglycemia. I have it very bad and it started off slow...