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Hypoglycemia and Gastric Surgery

Hypoglycemia means low blood sugar. After someone has had any gastric surgery, including sleeve gastrectomy and gastric bypass, they can have problems with hypoglycemia. Symptoms include any or all of:

  • extreme sleepiness
  • light headedness
  • sweating/cold sweats
  • shakiness
  • confusion
  • pale skin
  • heart racing
  • anxiety

Hypoglycemia in a gastric surgery patient is a very different situation from someone who has not had gastric surgery because it can happen from too much sugar or carbohydrates, or fatty foods or just too many calories at one time. This is part of what we call “dumping syndrome.” It can also happen if someone goes too long of a time - usually 8 hours or more, without consuming any calories at all.

The best way to avoid hypoglycemia is to have frequent low-carbohydrate meals. This does not mean it is good to snack all the time or “graze,” but it means having something five or six times per day. For example 3 meals, and 2 or 3 small snacks. Snack examples are: nuts (not peanut butter), beef jerky, a small cheese snack like a Baby-Bell, a slice of deli meat, a low-sugar protein bar or protein drink, fresh fruit or dried fruit without added sugar.

Often people who are experiencing symptoms of hypoglycemia or have a low blood sugar on a finger-stick test are told to eat or drink a lot of sugar to get the blood sugar up. This is not what you should do if you have had gastric surgery. It can actually make things worse - like pouring gasoline on a fire. If you feel symptoms of hypoglycemia, eat or drink something that has protein and little or no carbohydrates like the examples given above for preventing low blood sugar. If that does not work and/or if symptoms are severe or the blood sugar reading is very low - seek medical attention immediately (call a physician or 911).

Often people are told to drink supplements like Ensure or Boost to get their protein in. Do not drink these if you have had gastric surgery, unless it is the “diabetic” version. They can make you very sick with dumping syndrome and a very low blood sugar because they have so much sugar and carbohydrates in them.