Reactive Hypoglycemia Following Gastric Bypass Surgery

Patient Expert

Reactive Hypoglycemia Following Gastric Bypass Surgery
The benefits of bariatric surgery are impressive. It is an effective
approach for addressing obesity as well as the accompanying health risks associated with obesity. Weight loss can alleviate or minimize health
issues, such as high cholesterol, diabetes, high blood pressure, sleep
apnea, and cardiovascular problems.

Overall, bariatric procedures have been shown to decrease the mortality rate in the obese population. As the popularity of the procedure has
increased in the last decade, so has the rate of complications. Among
these complications is reactive hypoglycemia.

What Is Reactive Hypoglycemia?
Reactive hypoglycemia is one of two types of hypoglycemia that can occur
in people who do not have diabetes. Reactive hypoglycemia is also called
postprandial hypoglycemia and occurs within four hours after meals.

Most people who develop the condition have had their digestive tract or digestive system damaged from some type of surgery. This condition
causes blood sugar levels to drop after a meal due to an increase of
insulin production in the digestive tract or the body. So much of the
hormone is released into the blood stream that the distribution of
glucose to body cells increases to the point that the available blood
sugar becomes depleted. Too much insulin in a glucose depleted system
creates a hormonal imbalance known as hypoglycemic state.

Symptoms of Reactive Hypoglycemia
The symptoms of reactive hypoglycemia will present in the aforementioned four-hour window after meals. The illness can be difficult to diagnose because other illnesses have similar symptoms, although blood testing will produce an accurate identification.

Symptoms of reactive hypoglycemia include hunger or nausea, weakness,
anxiety, clammy hands and sweating, dizziness, headaches, sleepiness,
mental confusion, irritability and mood swings. All of these symptoms
are indicative of low blood sugar.

What To Do
Mealtime changes can normally keep blood glucose levels under control
and prevent the symptoms of reactive hypoglycemia.

Eating five or six small meals per day can help, whereas going too
long without eating can bring on unwanted symptoms. High fiber and low
glycemic index foods can help keep blood glucose levels in check.
High fiber foods include lentils, dried beans, peas and whole grains.
Plenty of fluids should be consumed if the amount of fiber in your diet
is increased. Low glycemic index foods include lentils, kidney beans,
chickpeas, apples, plums and oranges.

Protein foods should be had at each meal and as snacks and include meat,
poultry, fish, eggs, dried peas, tofu, peanut butter, milk, yogurt and

Sweet foods such as juice, sugar, jam, candies and honeys should be
limited or avoided, as should alcohol. Some conversation with a doctor
should be had regarding alcohol use.

Caffeine should be avoided altogether because it can make symptoms
worse. Talk with your doctor if you're experencing hypoglycemia.

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American Diabetes Association
Glycemia 101
Keck School of Medicine of USC
National Diabetes Information Clearinghouse
National Institute of Health