The Unexpected Low: Navigating MNT in Post-Bariatric Hypoglycemia

Description

Learning Objectives

• Describe physiological mechanisms and clinical presentation of post-bariatric hypoglycemia to strengthen foundational knowledge, enhance early recognition, and reduce delays in providing appropriate, effective patient care.
• Apply evidence-based nutrition strategies—including macronutrient distribution, meal timing, and behavioral interventions—to reduce hypoglycemia frequency and severity, directly improving safety, daily functioning, and overall clinical outcomes.
• Integrate emerging technologies and research, including continuous glucose monitoring and evolving pharmacotherapy, into PBH care to enhance monitoring precision, counseling effectiveness, and informed clinical decision-making.

Performance Indicators

• 11.2.9 Gathers and evaluates information that affects intake and nutrition and health status (e.g., behaviors, beliefs, knowledge, cultural, religious, ethnic, psychosocial, and social determinants of health) that influence nutrition and health.
• 11.3.9 Leads the implementation of nutrition interventions in collaboration with clients/patients and the interprofessional team.
• 11.5.2 Monitors and communicates factors and barriers affecting client/patient progress in meeting goals.

Speakers

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  Nicole Patience

  Diabetes Care and Education Specialist, Joslin Diabetes Center

  Nicole Patience is a bilingual Registered Dietitian, Certified Diabetes Care and Education Specialist and Certified Eating Disorder Specialist Consultant at the Joslin Diabetes Center in Boston. Her areas of interest includes diabetes technology and pattern management, eating disorder prevention and treatment, hypoglycemia, and the Latinx clinic. As part of the Hypoglycemia Clinic at Joslin Diabetes Center, Nicole offers nutrition counseling to support clients with post-bariatric hypoglycemia. She aligns with individuals as they navigate the complexities of a diet with a goal of both safety and cultivation of a healthy relationship with food and body. She is experienced in providing weight-inclusive 1:1 nutrition counselling and diabetes education, clinician training on treatment and awareness of eating disorder-informed care, and community outreach including seminars, nutrition workshops, and cooking demonstrations. Beyond Joslin, Nicole contributed to the Academy of Nutrition and Dietetics academic standards development of the weight inclusive toolkit intitiative. She also serves as a Senior Clinician at the Counseling and Nutrition Center 360, a private practice focused on eating disorders where she provides nutrition counseling and professional supervision.

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  Janine Suarez

  Endocrinologist, Joslin Diabetes Center

  Dr. Janine Suarez is a physician trained in Internal Medicine and Endocrinology. She received her medical degree from FIU Herbert Wertheim College of Medicine. She completed her residency at Mount Sinai Medical Center and her fellowship in Endocrinology at the University of Florida.  She currently works at the Joslin Diabetes Center and Beth Israel Deaconess Medical Center, where she sees patients with diabetes and other endocrine and metabolic diseases. She sees patients in the Hypoglycemia clinic at Joslin alongside Dr. Mary Elizabeth Patti and her interdisciplinary team.

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  Mallory Sin

  Diabetes Care and Education Specialist, Joslin Diabetes Center

  Mallory Sin is a registered dietitian and diabetes educator located in Boston. She works at Joslin Diabetes Center as an adult educator. Her areas of interest include diabetes technology and weight management. She works with Dr. Patti and Dr Suarez in hypoglycemia clinic - a specialty clinic at Joslin dedicated to hypoglycemia. She also teaches in the Why WAIT program (12-week weight loss program) and the T2 and you classes. She enjoys collaborating with other providers to provide holistic care for patients in medically complex circumstances. She is experienced in education both on a community level through seminars and workshops as well as 1:1 counseling. She uses motivational interviewing as well as intuitive eating principles to help her patients achieve healthy relationships with food and themselves while working towards goals that can improve their health outcomes.

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Moderator

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  Sandra Arevalo

  Director of Community Health & Wellness, Montefiore Nyack Hospital

  Sandra is a bilingual independent consultant and also serves as Director of Community Health & Wellness at Montefiore Nyack Hospital. Her Latina heritage and experience around the world have contributed to her commitment to promote disease prevention among the most underserved and diverse families, including people without homes and the LGBTQ+ community. With almost 30 years of experience, she is a recognized national expert and speaker on diversity, health education, diabetes, nutrition, chronic diseases, health equity and social determinants of health. Her work has been featured in national and international TV, numerous printed media outlets, radio, and peer reviewed journals. She volunteers for the Academy of Nutrition and Dietetics as spokesperson and a member of the nominating committee. She is also a spokesperson for the American Association of Diabetes Care & Education Specialists and has volunteered on the board of other various professional organizations. Sandra has received numerous nominations and awards such as LAHIDAN’s Trinko Award (2023), Mom On A Mission, next to Michelle Obama (2017) and the Garden State Diabetes Educator of the Year Award (2018), among others. She is currently pursuing her Doctorate in Public Health.

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