Hypoglycemia is a clinical condition that occurs when blood glucose levels becomes less than 3.0 mmol/L. According when the symptoms occur (before or after meal) there are 2 general types of hypoglycemia:
I. Hypoglycemia when hungry, and
II. Hypoglycemia after eating (reactive hypoglycemia)
I. Hypoglycemia after eating occurs 8-9 hours after the last meal. This type of hypoglycemia is due to disturbed balance between creating glucose in the liver and spending glucose by the body. There are 2 general possibilities:
A. Decreased production of glucose by the liver and
B. Increased spending of glucose by the rest of the body.
Decreased production of glucose can be due to:
1. Lack of the necessary hormones during some conditions (pituitary gland failure, Addison’s disease, deficit of kateholamins (adrenalin and noradrenalin) and lack of the hormone glucagon);
2. Lack of the necessary enzymes;
3. Acquired liver diseases (hepatitis, cysosis).
- Increased spending of the glucose by the body is present in these conditions:
1. Tumors that produce insulin;
2. Overdosing with insulin;
3. Overdosing with sulfonylurea;
4. Endotoxic shock;
5. Tumors that produce substances similar to insulin;
6. Lack of fat tissue after prolonged starving;
7. Lack of some enzymes.
II. Reactive hypoglycemia occurs soon after meal rich with carbohydrates. It happens in several conditions:
1. Very fast glucose absorption due to total or partial stomach removal (gastric bay-pass);
2. Congenital fructose intolerance;
3. Leucin intolerance, and
4. Idiopathic type (probably psychosomatic).
In your case, the hypoglycemia symptoms that you are experiencing are probably the reactive-type and caused by the surgery (gastric bay-pass).
Panic disorder and depression aren't generally caused by a gastric bay-pass nor are symptoms of hypoglycemia. Rather, panic attacks and depression are separate disorders and can't be symptoms of any other disorder. Nevertheless, the symptoms of a panic disorder can be similar to symptoms of hypoglycemia (swelling, tachycardia, shaking, anxiety, fear etc.). Drinking has nothing with the gastric bay-pass, either.
Pancreas removal is recommended if hypoglycemia is caused by a tumor that produces insulin (insulinoma). Such tumors are located in the pancreas. In cases of hypoglycemia caused by gastric bay-pass, hypoglycemia can be prevented with proper diet: eating small meals rich with proteins and fats but poor with carbohydrates ... frequently. You can try to completely rest 2 hours after meal also. To follow up, you can consult an endocrinologist about your condition.
