@jc76 hello again. I am the poster who mentioned “the diabetic rollercoaster”. Let’s talk more.

I’m sorry about your wife’s stomach surgeries and damage to the vagus nerve. The brain controls the operation of everything else all over the body by using the nervous system to carry messages. Diabetes can damage these nerves resulting in diabetic neuropathy. Damaged nerves that control internal functions is called autonomic neuropathy. This is usually the cause of gastroparesis. Gastro- means stomach and paresis- is like paralysis. Simply put it is a slowing of stomach emptying such that food does not move through the digestive system as it should.

Stomach surgeries aren’t typically the cause of gastroparesis or vagus nerve damage. It usually originates with uncontrolled diabetes.

I am sorry about your wife’s left eye damage due to her diabetes. This is another example of what uncontrolled diabetes can do. The A1C test shows how the blood sugars have been over a period of time. Non diabetics measure around 5. Controlled diabetics are under 8. Your wife’s team is concerned for her safety when they cancelled her eye surgery due to an A1C of 9. Uncontrolled diabetes increases risks of there being unpleasant complications during surgery and makes healing & recovery more difficult.

I’ve talked a lot about uncontrolled diabetes. You mentioned your wife’s lows going way down, having to drink glucose, then having highs into the 300’s. This is “the rollercoaster”!

At Mayo Clinic Connect we members should not diagnose. This is not a diagnosis. Your wife’s situation sounds very familiar from my own experience. We share our stories to offer hope and encouragement. Here’s mine. Low blood sugars are VERY scary and make you feel completely out of control. You can’t wait for things to improve and will do anything to get better fast. This can easily result in overtreating the low such as eating or drinking everything but the kitchen sink! That causes a spike in blood sugars, then the need for correction insulin, then you’ve gotten onto a never ending rollercoaster cycle.

When low I was taught to test blood sugar using a meter. (Some continual glucose monitors / CGM’s are not accurate with lows, less than 40 or highs, greater than 300 - 400’s.) If the test is low (my low number from my provider is 70 or less) consume 15 grams of carbohydrate and WAIT 15 minutes. Then repeat. This is called the 15 - 15 rule. I use 15 grams of fruit juice which is about 1/2 - 1 cup depending on the juice. Learn to read the carbohydrate content on the nutrition label. The liquid is quickly absorbed, no digestion needed which is helpful for gastroparesis. The waiting is really hard to do but prevents overtreating and the resulting spike in blood sugar then the rollercoaster. The only exception to this is that if the blood sugar is REALLY low (for me this is less than 40) start with 30 grams of carbohydrate.

I hope this is helpful and useful to you and your wife. We would be happy to welcome her to Mayo Clinic Connect. We love to support each other as best we can.