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Gastric Sleeve and Hypoglycemia: Understanding Complications

By Fernando Garcia on August 26, 2015 Dr. Fernando Garcia always ensures that patients at his Tijuana practice get all the information they need when it comes to gastric sleeve surgery and other options for surgical weight loss. Providing information about the side effects and potential issues after all procedures gives patients realistic expectations about the life after surgery.

In recent years, we've noticed a number of pieces about hypoglycemia following bariatric surgery. Let's take a moment to consider this issue and what can be done about it.

About Reactive/Postprandial Hypoglycemia

Reactive or postprandial hypoglycemia is a potential complication of weight loss surgery that occurs when a bariatric surgery patient's blood sugar dips very low. It can affect people who have undergone gastric sleeve or any sort of bariatric surgery procedure.

One study on this condition was conducted by Dr. Johanna-Maria Brix with her colleagues at Rudolfstiftung Hospital in Vienna. Of 219 recent bariatric surgery patients monitored for two years, 34% of them demonstrated severe hypoglycemia after they were given a dose of sugar. These findings were presented at the American Diabetes Association Meeting in San Diego in 2011.

It should be noted that these issues typically develop after two to three years following surgery, and that the majority of those studied had undergone a gastric bypass. Regardless, this is something that all patients need to take seriously.

Why does reactive hypoglycemia occur?

Reactive hypoglycemia occurs when a patient who has undergone bariatric surgery ingests a meal that is high in carbohydrates.

Recent studies have suggested that these cases of hypoglycemia are linked to the presence of a hormone known as Glucagon-like Peptide 1 (GLP-1). These hormone levels are enhanced following bariatric surgery, and make issues with hypoglycemia more likely.

Symptoms of Reactive Hypoglycemia

Symptoms of reactive hypoglycemia of which patients should be mindful include:

Sometimes the issues with hypoglycemia are so bad that they cause patients to pass out.

How to Avoid Issues with Hypoglycemia

The best way to avoid issues with hypoglycemia following bariatric surgery is for patients to be very mindful of the foods that they are eating. Diets should be balanced and patients should avoid carbohydrate-rich foods and meals. Bariatric surgeons can provide patients with detailed dietary tips that help patients avoid foods that can cause hypoglycemia as well as dumping syndrome.

Some studies have found that GLP-1 inhibitors are effective at preventing hypoglycemia in bariatic surgery patients as well. These may be recommended if patients notice issues with hypoglycemia following surgery.

Other Matters to Consider Going Forward

As we've stressed before on our blog, bariatric surgery is a part of a lifestyle change that helps you achieve a more ideal weight and good overall health and wellness. Patients should be mindful of this going forward and we will be more than happy to help with lifestyle adjustments and improvements that will allow you to lead a healthier lifestyle moving forward.


For more information about gastric sleeve surgery and how it can help you achieve better overall health and wellness, be sure to contact our weight loss surgery center today. Dr. Fernando Garcia and the entire team here looks forward to helping you lose weight and achieve a more ideal body mass.


