Low Blood Sugars after Gastric Sleeve or Bypass
By Erica F Perusse, BFC virtual assistant and future dietitian
Low blood sugars after Gastric Sleeve, Bypass, or Duodenal switch can be a real game-changer on the post-surgery journey. Imagine this: you’re cruising along, making progress, feeling great, and then bam! Your blood sugar throws a curveball, leaving you feeling shaky, sweaty, and downright drained. It’s like hitting a speed bump on the road to success. But fear not, fellow bariatric friends!
While hypoglycemia might be a bump in the road, it’s NOT a roadblock. So get ready to be armed with the right strategies and support to skillfully navigate low blood sugars, staying focused, energized, and prepared to tackle whatever challenges come your way.
Blood sugar levels in our body
Blood sugar levels naturally rise and fall throughout the day. When they drop below 70 mg/dL, it’s called low blood sugars or hypoglycemia. This condition may also be referred to as postprandial hyper-insulinemic hypoglycemia, reactive hypoglycemia, or late dumping syndrome, particularly after bariatric surgery.
Since low blood sugars after Gastric Sleeve or Bypass can vary in symptoms, it’s crucial to be attentive to your body’s signals and have an Emergency Kit ready to restore your blood sugar levels to normal.
Some examples of signs and symptoms are:
Introducing a roadmap for navigating low blood sugars after Gastric Sleeve or Bypass
To help you skillfully navigate blood sugar dips, I’ve created this handy dandy roadmap to keep your blood sugars more regulated and feeling your best. If you’re following along this map and still struggling with low blood sugar after Gastric Sleeve and Bypass, please book an appointment with your bariatric surgery team.
Continue straight on Bariatric Pillars
In the iconic audible car map voice, ‘Continue straight ahead on Bariatric Pillars.’ You may recall that those pillars are water, meal planning, movement, sleep, and vitamins. These pillars are helpful and friendly reminders, especially for those navigating blood sugar fluctuations.
For a speedy recap of these pillars, take a look at these blog posts:
Bariatric Pillar #1: Water! (Some rules have changed…)
Bariatric Pillar #2: Meal Planning (boring…)
Bariatric Pillar #3: Movement (cuz exercise is a bad word)
Bariatric Pillar #5: Vitamins for LIFE??
Turn Left onto Meal Planning
Meal planning doesn’t have to be daunting, but if you’re experiencing low blood sugar after Gastric Sleeve or Bypass, it is an absolute must.
On our roadmap, we will drive onto Meal Planning, where we will break down your bariatric plate.
Plan your three meals a day around protein and pair it with low-starchy vegetables. If you’re going to eat a snack, pair it with protein. Even fruit can cause drops in blood sugars a couple of hours later if not paired with something like a cheese stick or boiled egg.
Protein will help slow the digestion of carbohydrates and help blood sugars stay more even until your next meal. As Steph always says, eat two bites of the protein to one bite of something else to keep protein as the priority.
Take small bites, go slowly, and stop at the first sign of fullness. No need to stress the portion size if your focus is on the protein. You can trust your body (and your pouch) to tell you when enough food is enough.
If you need more help with meal planning and how to build your meals, check out Steph’s newest course “Food Fundamentals” inside Premier Access!
When it comes to bariatric patient plates, it’s often emphasized to prioritize protein first, followed by vegetables, fruits, and fats. However, it’s important to take a brief detour to understand the role of carbohydrates and heart-healthy fats.
While starches may be added later in your journey as recommended by your dietitian, it’s crucial to be aware of which carb sources will benefit your blood sugar. Opt for low sources of carbohydrates that digest slowly in the body, as these are preferred. Keep in mind that sources high in carbohydrates may lead to blood sugar dips. Additionally, it’s important to include heart-healthy fats as recommended. Here are two examples of each source.
Next, Go straight towards Hydration.
I know water is a big deal after bariatric surgery, but why does it matter regarding low blood sugars?
Consistent sipping is key! Keep hydrating daily—it’s crucial for weight control and helps you feel more energized. So, buckle up–we are aiming to combat your thirst!
Water and our bodies. Ever wake up feeling super thirsty? That’s because overnight, you’ve lost quite a bit of water through sweat. Sources of hydration. You don’t have to stay hydrated by sipping on a glass of water (room temperature, iced, or even hot) all day. There are many ways to mix it up and still fuel your water tank.
Sugar-free popsicles
No sodium broth
Zero-sugar electrolyte drinks
Warm or cold caffeine-free teas
Find a way that works for you to hydrate throughout the day to get your body moving in the right direction. Just a heads up! When you drink water with your meals, it can make your stomach empty faster. This might make you feel hungrier sooner and lead to eating bigger portions later on.
Turn left onto Monitoring Meal Time
Ideally, breakfast is eaten within the first sixty to ninety minutes of waking up in the morning. Something with protein to “break the fast” hence the name!
Patients are different in the spacing of meals for best sugar control. YOu might aim for no more than 4 hours without eating a protein-based meal or snack, but adjust based on your symptoms.
One of the earliest signs that your blood sugar might fluctuate is how you feel before and after a meal. These changes can happen slowly, but sometimes, your body might experience a sudden dip without much warning. Be mindful of symptoms like nausea, lightheadedness, and physical reactions such as shaking or excessive sweating. While recording these details at the moment is unnecessary, it’s helpful to note what happens once your blood sugar is back on track.
Sticking to a consistent meal schedule can be challenging, especially during busy days, illness, or travel. That’s where consuming small, frequent portions of food, including meals and snacks, becomes beneficial. Protein is helpful because it digests slowly and gradually affects blood sugar levels. Always pair a carbohydrate-containing food with a protein source.
Research suggests that reducing carb intake during meals can prevent quick spikes in blood sugar after eating. This helps regulate insulin release, preventing sudden drops in blood sugar and the symptoms of reactive hypoglycemia.
Monitoring blood sugar levels is crucial because sometimes our bodies may not exhibit “typical” signs and symptoms of fluctuations. It’s possible that your body has adapted to lows and highs, and you’re only now recognizing them. Regardless, utilize your glucose meter to track and record your levels before and after meals or snacks.
Turn right toward the Emergency Kit
Just like you need an emergency kit for your car to help during times of distress (flats, accidents, etc.), you need one for blood sugar fluctuations.
1- Track your food, signs and symptoms, and blood sugar levels.
Keep tabs on your daily eats with a food diary—it’s like being a detective for your blood sugar! Look out for patterns that might trigger those pesky highs and lows. Feeling a bit off? Note any signs and symptoms you’re experiencing (check out the chart for reference).
If you’ve got a glucose monitor handy, jot down those readings too! If this feels like a lot, start small. Any information is better than none, especially if you are currently in a low.
2- Pack Bariatric Friendly Snacks
Don’t leave home without your Emergency Kit snack—it’s a must-have! Whether it’s stashed in your purse, backpack, car, or desk, having a go-to snack is key to avoiding the hills of blood sugar levels. Aim for consistency with a balanced snack that packs protein, quick carbs, and a touch of healthy fats.
You are in the right place if you need some help with snack ideas! Here are some helpful items to keep on hand in case of an emergency.
Note: Ideally you catch your blood sugar before it’s dangerously low. If your blood sugar is lower than 55 mg/dL – get a simple carbohydrate in your body fast. If it’s starting to dip under 70 mg/dL, use one of these options that pairs protein and carbohydrates together.
Sources of good protein options:
low-fat cheese sticks or baby bell cheese
2% cottage cheese 0% fat Greek yogurt, plain (but add some sweetener unless you really like sour cream)
Eggs (hard-boiled or deviled are excellent for a snack)
Beef jerky (flat ones, not the stick kind)
Low-sugar protein drink (EAS carb control or Atkins shakes are good)
Low-sugar protein bars (this is a good option if your blood sugar is already low and you need to bring it up more on that in a bit)
Foods to avoid/be mindful of:
Fruit. If you’re opting for fruit, go for low-sugar options like berries, and make sure to eat your protein first. Beginning with protein can help slow down the rise in sugar levels caused by fruit.
Nuts/Peanut Butter. It’s a very, very common belief that nuts and peanut butter fall into the protein category. They do contain protein, but not nearly as much as fat. If you are trying to maintain or lose weight, be incredibly mindful of nuts and nut butter.
Juice. When blood sugar drops, some are told to drink juice or have candy, which can spike blood sugar too quickly, leading to another low. Pairing carbohydrates with protein, like a protein bar or fruit with cheese, is a better choice. Unless your blood sugar is under 55 mg/dL and you need to raise it fast.
3- Create a Plan
Experiencing blood sugar dips can be downright scary—I’ve been there myself! Trust me, confusion takes over when it hits, and clear thinking goes out the window.
That’s why having an ‘in case of emergency’ plan is an absolute must. Knowing how to react when your blood sugar dives is crucial, even if you never end up needing it. And for those of us who’ve had bariatric surgery, preparation is key!
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Take a slight left towards Support.
Seeking support is essential for bariatric patients facing hypoglycemia, as handling these episodes alone can be daunting. It’s completely acceptable to rely on loved ones and healthcare professionals for emotional support and advice in effectively managing hypoglycemia. With various blood sugar medications available nowadays, it’s advisable to discuss with your healthcare provider whether it’s suitable for your daily routine.
Additionally, support networks, like Bariatric Food Coach, can offer understanding, empathy, and practical tips from those who have been through similar challenges. By leaning on these support systems, bariatric patients can feel empowered, reassured, and better equipped to handle the ups and downs of their post-surgery journey.
You have reached your destination!
As always, consult your dietitian or primary care provider for a more personalized plan or recommendations based on your preferences and goals.
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