Hypoglycemia, also known as low blood sugar, is an uncommon but unpleasant experience that both bariatric and non-bariatric patients may encounter. Symptoms of hypoglycemia may include feeling lightheaded, increased perspiration, dizziness, weakness, blurred vision, confusion, excessive hunger, and/or increased heart rate. Severe cases of hypoglycemia have the potential to cause seizures, fainting or loss of consciousness and requires immediate medical intervention.  

After bariatric surgery there are several reasons a patient may experience a dip in blood sugar resulting in these symptoms. Not eating for extended periods of time and dumping syndrome are the most common causes. Dumping syndrome is secondary to changes in the storage function of the stomach and/or emptying mechanism which occurs due to the rapid transfer of solids and liquids into the duodenum (or small intestine). Dumping syndrome can be categorized into two forms, early and late dumping syndrome.

Early dumping syndrome is caused from increased blood flow to the intestines that occurs when food is rapidly dumped into your small intestine. During early dumping syndrome, you will develop symptoms of weakness, fainting, irregular heartbeat, sweating, dizziness, decreased blood pressure, abdominal cramps, and then diarrhea 30-60 minutes later. When there is sudden dumping of food and fluids into the intestine, the body produces excess insulin to decrease your sugar levels.

Late dumping syndrome occurs 1-3 hours after eating. When you consume sugar, it is quickly absorbed into the bloodstream which causes a rapid rise in blood sugar levels, the pancreas responds to elevated blood sugar by releasing insulin to absorb the excess sugar. When the amount of insulin surpasses the amount of sugar, it causes symptoms of sweating, anxiety and tremors, headaches, fatigue, faintness.

 There are several ways to prevent the occurrence of hypoglycemia. Eating protein first, consuming a well-balanced diet with fiber, avoiding simple sugars (such as cookies, candy, cake, barbeque sauce), eating small, balanced meals frequently throughout the day, and avoid eating carbs on an empty stomach. Eating carbs on an empty stomach causes blood sugar levels to spike and then plummet at a rapid rate. Consuming foods like black beans or sweet potatoes that are lower in glycemic index will not raise your blood sugar as fast and slows down digestion.

To prevent the occurrence of hypoglycemia, follow the diet guidelines recommended by your bariatric surgeon and:

  • Monitor your blood sugar closely
  • Avoid caffeine
  • Do not skip meals
  • Eat protein first
  • Avoid starchy vegetables, pasta, bread, cereal, flour and sugar and instead choose complex carbs like whole grains
  • Eat complex carbs
  • Space meals out by eating every 3-4 hours
  • Consume high fiber foods to slow digestion