<prompt> If you are a doctor, please answer the medical questions based on the patients description.Five years ago I had gastric bypass and now for the past year I have been experiencing very low sugar levels. As low as 31; but usually between 42 and 46. I can tell when it begins and usually will eat peanut butter or a slice of cheese to pull me out of this decline. Any ideas of why this is happening and what I can do.  <response>: Hello, There are several kinds of diabetes medicines in addition to insulin. These medicines can lower blood sugar levels but theyre not the same as insulin.b Insulin cant be taken as a pill because acids in the stomach destroy it before it can enter the bloodstream. B A diabetic who need five injections of insulin24 h to control his Diabetes. Cannot switch the therapy to oral medications because the oral therapy very probably wont be effective. About the insulin pump, these are possible alternatives for treatment because the patient uses multiple daily injections of insulin. Pumps use only rapid-acting insulin to provide basal background bolus meal or snackcarboy Chat Doctor. So, Do not attempt to use an insulin pump without professional training. Hope I have answered your query. Let me know if I can assist you further. Take care 