Type 2 and hypos

[BarbieThain]

Hi. Please forgive the long post.

I was diagnosed type 2 diabetic in 2013 (diabetes is in both sides of my family), in 2014, I had a gastric bypass. I've gone on to lose 10st.
At the back end of 2015 I had an unexplained seizure, BG had gone below 2. Since then I've had 4 or more dilly dos (as I call them).
The thing is they are getting really annoying, really scary, and absolutely wipe me out, and I no longer go out without my hubby, my poor 8yr old daughter has witnessed one of my dilly dos (veg aisle at Asda of all places), and if I go out with her she makes sure I've got my glucagon in my handbag and she knows the passcode for my phone if hubby is not nearby. My work colleagues are constantly on dilly do watch (I work in a residential home so they have enough to do without keeping a beady eye on me too).
This week, my BG dropped to 1.9 (no dilly do), went to Tesco BG dropped to 3.4 and was on the verge of dilly doing, hubby forced me to sit down (I tend to get naughty and disobedient). Was out today with my daughter (rare girly day out) BG 10.9 when we set off out, again nearly had a do and when I checked my BG it was 4.5, had only been out about 30 mins.
Off to have a discussion with my GP on Tuesday, as it's now beyond being funny.
Has anyone else had gastric surgery or is T2 and suffers like this. Also is it normal to have a headache for a couple of days after a hypo?

 

[Winnie53]

@BarbieThain Not sure. Curious. I'm not knowledgeable about gastric bypass. Are the hypos due to taking one or more diabetic medications, injecting insulin, or eating high glycemic foods? Are you eating meals/snacks that are balanced - (a mix of healthy fat, protein, and plant-based carbs) - both in adequate amounts and frequently enough?

 

[BarbieThain]

Hi Winnie53, I no longer take medication for my diabetes, I was on meteor in but it was stopped the day after my bypass as my BG started to drop to a normal range. I'm very limited as to what I can eat due to the bypass. I eat quite healthy, as I don't want the kids to end up with diabetes and I tend to watch what the hubby eats too. Everything I cook is cooked from scratch, I always have plenty of fruit in (tend to avoid high sugar fruits) and we never have takeaways.
What I have found is that I can have breakfast before I go to work and by 8.30/9am my sugar is low, if I don't have anything until 10.30 (brew time) I'm fine!
I guess what I'm scared of most is ending up like my grandma, she lost both her legs to diabetes due to infections and unfortunately we lost her. (Don't get me wrong she still enjoyed herself after her first amputation)

 

[Winnie53]

That's very helpful. Thank you.

I think you need to have a conversation with those on the reactive hypoglycemia forum here... http://www.diabetes.co.uk/forum/category/reactive-hypoglycemia.70/

Also, do you know of any forums for living with gastric bypass surgery?

I think we can help, but to do so, we need you to educate us as to how eating works for you now. There are three macronutrients: protein (essential amino acids), fat, and carbohydrate. How do you get each of these with your "meals".

I'm going to be away from the computer for the rest of today...apologies... Going to tag two people who I think may be able to provide you guidance on hypoglycemia...

@Lamont D @Brunneria

Will check back in with you tomorrow.

 

[Lamont D]

Hi. Please forgive the long post.

I was diagnosed type 2 diabetic in 2013 (diabetes is in both sides of my family), in 2014, I had a gastric bypass. I've gone on to lose 10st.
At the back end of 2015 I had an unexplained seizure, BG had gone below 2. Since then I've had 4 or more dilly dos (as I call them).
The thing is they are getting really annoying, really scary, and absolutely wipe me out, and I no longer go out without my hubby, my poor 8yr old daughter has witnessed one of my dilly dos (veg aisle at Asda of all places), and if I go out with her she makes sure I've got my glucagon in my handbag and she knows the passcode for my phone if hubby is not nearby. My work colleagues are constantly on dilly do watch (I work in a residential home so they have enough to do without keeping a beady eye on me too).
This week, my BG dropped to 1.9 (no dilly do), went to Tesco BG dropped to 3.4 and was on the verge of dilly doing, hubby forced me to sit down (I tend to get naughty and disobedient). Was out today with my daughter (rare girly day out) BG 10.9 when we set off out, again nearly had a do and when I checked my BG it was 4.5, had only been out about 30 mins.
Off to have a discussion with my GP on Tuesday, as it's now beyond being funny.
Has anyone else had gastric surgery or is T2 and suffers like this. Also is it normal to have a headache for a couple of days after a hypo?

Hi @BarbieThain

Firstly, I have not had gastric bypass or am type 2.

But I do have a condition that is the type of symptoms you describe, Hypoglycaemia.

I would like you to read the reactive hypoglycaemia forum as this will give you an idea as to what is happening to you!
You do not have RH!

What you have is symptomatic with Hypoglycaemia.
It is becoming more common to see this in people with gastric bypass.
Because of the bypass, you digest food differently and your chemical and hormonal response particularly insulin, has changed, and the extra insulin is creating the lows (hypos) the quick digestion of foods leads to higher blood glucose levels (hypers).
The quick digestion leaves the high levels of insulin.
Because your insulin resistance has dropped due to the bypass, your insulin response is better, again more insulin.
I do agree you should have a chat with your GP, but you must have a specialist, ask him/her.
However, the way to avoid the hypers, is to avoid the food that does it, usually carbs and sugars.
You will need a monitor to test and a food diary to record everything. You will have to test every food to see how intolerant you are to that particular food. If you avoid these foods, you won't produce the insulin, so no hypers, no hypos!

My condition is very similar.
Very low carbing works.

Best wishes and great weight loss.

 

[BarbieThain]

Hi thank you so much for your reply and for your insight into what could be happening, I will start keeping a food diary and monitor my BG after meals.
It doesn't matter how many people you see before the actual gastric op, no one actually tells you properly what is going to happen to your body as truthfully I don't think they really know.

Again thank you so much for all the information in you reply.

Hi @BarbieThain

Firstly, I have not had gastric bypass or am type 2.

But I do have a condition that is the type of symptoms you describe, Hypoglycaemia.

I would like you to read the reactive hypoglycaemia forum as this will give you an idea as to what is happening to you!
You do not have RH!

What you have is symptomatic with Hypoglycaemia.
It is becoming more common to see this in people with gastric bypass.
Because of the bypass, you digest food differently and your chemical and hormonal response particularly insulin, has changed, and the extra insulin is creating the lows (hypos) the quick digestion of foods leads to higher blood glucose levels (hypers).
The quick digestion leaves the high levels of insulin.
Because your insulin resistance has dropped due to the bypass, your insulin response is better, again more insulin.
I do agree you should have a chat with your GP, but you must have a specialist, ask him/her.
However, the way to avoid the hypers, is to avoid the food that does it, usually carbs and sugars.
You will need a monitor to test and a food diary to record everything. You will have to test every food to see how intolerant you are to that particular food. If you avoid these foods, you won't produce the insulin, so no hypers, no hypos!

My condition is very similar.
Very low carbing works.

Best wishes and great weight loss.

 

[Brunneria]

Hi and welcome.

I agree with @Lamont D you are not the first person who has posted with hypos after gastric surgery, so if you go back to your medical team and ask them about it, they should be able to help.

And can i urge you to start calling them hypos, or hypoglycaemic episodes? If you continue to call them 'dilly dos' i could see a scenario when you did not end up with the appropriate medical/hypo treatment, especially if co-workers and family don't fully understand what is going on.

Having said that, i have every sympathy with you. I always liken a hypo (at the numbers you quote) as feeling like I've been run over by a bus. And yes, like you, i can easily have symptoms for a day or two later. I don't get a headache, but i've seen posts from people who do. hypo symptoms vary quite a lot between individuals.

From your description, you are getting several of these hypos a week, so please insist that your doctor arranges a priority referral, and supplies you with enough test strips for frequent testing.

You may find it VERY informative to keep a diary of exactly what, and when you eat, then record the time of your hypos, and how low your blood glucose went. There may be a link you can identify between certain foods and when you get hypos. Exercise and activity levels may also factor in.

Hope your appt at the docs goes well, and please come back and let us know how things go.

 

[BarbieThain]

I'm very strict with what I eat, I have to be! No sweets or sweets stuff as this can make me ill.i am limited to potatoes and brown bread, rice and pasta get stuck, meat has to be literally dead before I can eat it as again it can get stuck, food getting stuck can cause 'dumping syndrome'. I have no gall bladder either so am also particular with fats!
I have found the recipes on this website really good, I just tweak them a little bit with what I can and can't eat

That's very helpful. Thank you.

I think you need to have a conversation with those on the reactive hypoglycemia forum here... http://www.diabetes.co.uk/forum/category/reactive-hypoglycemia.70/

Also, do you know of any forums for living with gastric bypass surgery?

I think we can help, but to do so, we need you to educate us as to how eating works for you now. There are three macronutrients: protein (essential amino acids), fat, and carbohydrate. How do you get each of these with your "meals".

I'm going to be away from the computer for the rest of today...apologies... Going to tag two people who I think may be able to provide you guidance on hypoglycemia...

@Lamont D @Brunneria

Will check back in with you tomorrow.

 

[Jofster01582]

With the gastric bypass you need to eat little and often as opposed to 3 square meals a day .....had mine 6 years ago but back on insulin and tabs

 

[Lamont D]

Hi thank you so much for your reply and for your insight into what could be happening, I will start keeping a food diary and monitor my BG after meals.
It doesn't matter how many people you see before the actual gastric op, no one actually tells you properly what is going to happen to your body as truthfully I don't think they really know.

Again thank you so much for all the information in you reply.

In my experience with dealing with my condition and endocrine conditions. The doctors are only guessing.
I was lucky to find an endocrinologist who knew what the symptoms were doing to me but knew the tests required to get a true diagnosis.
Get a referral back and I have read articles and papers that refer to the symptoms you are having but then again, the this is all new and they are still guessing.

The advice about very small meals (preferably low carb) every three hours is really good advice. I was on this for a couple of years and it did prevent the symptoms.

The more knowledge you find the more will help you decide on how to get good control of your blood glucose levels.
If you do have a hypo, the rebound effect is just as bad, so have something low carb and have a small meal about fifteen minutes later.

This is why I said read our forum as there is some great information.

Best wishes

 

[Resurgam]

I'm afraid that the closest I have come to gastric bypass surgery is watching TV programs about it with a dreadful fascination at how drastic a solution it is and how blithely surgeons perform such a non reversible alteration in a person's anatomy.

I thought that after a gastric bypass it was necessary to eat low carb foods, yet you seem to be eating potato and bread.

I hope that the doctor will have some useful advice, but I suspect that only by doing a lot of monitoring and experimentation with your own diet will you find out how to balance your metabolism.

 

[SugarDaddy91]

I used to work at a gastro clinic and I may have some insight in the topic. One of my colleagues started having the same symptoms as you shortly after meals. She had started eating fast carbs recently and after every meal would get a good drop in the blood sugar.

The reduced size of the ventricle (stomach) can cause it to dump the amounts of food it has collected into the small intestine (known as dumping syndrome). This can cause a neural response called a "vaso-vagal"-response with a short hypotension and bradycardia.

Also as a side note, the stomach no longer has the same capability to portion out the food it sends into the small intestine. If the meal consists of fast-acting carbohydrates, it will be released at the same time into the small intestine, causing a very rapid increase in blood sugar. To respond to this, the pancreas will release a lot of insulin to normalize the blood sugar and usually this is beneficial because it usually means that there will be a persistant supply of sugars. But as the surgically altered ventricle has a very reduced capacitiy to "hold back" and "portion out" the meal, it will all be released and absorbed rapidly. So an increase in blood sugar followed by a rapid decrease are the typical signs. With the weight loss your pancreas should be able to act like this. I would recommend metering right after eating. Also, you could try a glucose tollerance test. It could create the same results.
Hope this help. Just some insight from my days of gastro-nursing.

EDIT:
We've had some success in treating these symptoms with LCHF. Seems to be an effective treatment for a lot of things these days.

 

[Winnie53]

Wow. @BarbieThain thank you for providing additional information. Just got home and am so wowed by the tremendous response you've received today. I had hypoglycemia through much of the 80's. It gets better once you learn how to manage it. I think you'll continue to receive excellent support both here and on the Reactive Hypoglycemia Forum. Best of luck to you!

 

[sasharhianna93]

Hi, I know this thread was initially for a question about hypos after having a specific surgery. I have not had any surgeries and have only been diagnosed since February of this year, and the last month or so I have been having very frequent and severe hypos. I am currently only on pills. No insulin. I have read that glipizide can sometimes cause this. Does anyone know if that's true? I did not have any problems with any of my medications for the first few months after being diagnosed. But my lifestyle has obviously changed a lot since the diagnosis and I now feel that the glipizide may be just a little too much for me. Any advice on how to bring this up to my doctor? I do not want to undermine her recommendations, but I just feel that something isn't quite right!

 

[Winnie53]

@sasharhianna93 I don't want to derail this topic because it's so important for those who have had gastric bypass surgery. I'm in the US too. I read your previous posts too, but haven't had time to respond. Apologies.

Could you start a new topic? I realize that didn't help you before, but could you give it one more try?

I'd also be willing to talk with you publicly or privately here or by phone. I'm in the US too, but on the west coast, so there's a bit of a time difference. I just PM'd you. What's happening to you doesn't make sense to me. I have a lot of questions. I'd like to help if I can.

 

[sasharhianna93]

To all of you on this thread I am so sorry. I did not mean to take away from the issue at hand!

 

[Lamont D]

Can@Administrator or @azure please start the post from @sasharhianna93 to another thread please?

However, if it is Glicizide that you are taking then you do need to speak to your GP.
This is a blood glucose lowering drug.
What you are getting symptoms of is because your body is used to high blood levels.
Because of the drug, your blood sugar is lower. Hence the symptoms.
Speak to your GP, you need a dosage change!

Best wishes

 

[Winnie53]

@sasharhianna93 you did nothing wrong. Your question was within topic.

The reason it would be helpful if you start a new thread, or provide more information on your previous thread, is because your circumstances are different from the original posters, that's all. And a lot more information is needed for us to be able to support you.