Post-gastric bypass hypoglycaemia: a review.

Published

Journal Article (Review)

Bariatric surgery is a highly effective treatment for severe obesity, resulting in substantial weight loss and normalizing obesity-related comorbidities. However, long-term consequences can occur, such as postbariatric surgery hypoglycaemia. This is a challenging medical problem, and the number of patients presenting with it has been increasing. Roux-en-Y gastric bypass (RYGB) is the most popular bariatric procedure, and it is the surgery most commonly associated with the development of postbariatric surgery hypoglycaemia. To date, the pathogenesis of this condition has not been completely established. However, various factors - particularly increased postprandial glucagon-like peptide (GLP)-1 secretion - have been considered as crucial mediator. The mechanisms responsible for diabetic remission after bariatric surgery may be responsible for the development of hypoglycaemia, which typically occurs 1-3 h after a meal and is concurrent with inappropriate hyperinsulinaemia. Carbohydrate-rich foods usually provoke hypoglycaemic symptoms, which can typically be alleviated by strict dietary modifications, including carbohydrate restriction and avoidance of high glycaemic index foods and simple sugars. Few patients require further medical intervention, such as medications, but some patients have required a pancreatectomy. Because this option is not always successful, it is no longer routinely recommended. Clinical trials are needed to further determine the pathophysiology of this condition as well as the best diagnostic and treatment approaches for these patients.

Full Text

Duke Authors

Cited Authors

  • Shantavasinkul, PC; Torquati, A; Corsino, L

Published Date

  • July 2016

Published In

Volume / Issue

  • 85 / 1

Start / End Page

  • 3 - 9

PubMed ID

  • 26840207

Pubmed Central ID

  • 26840207

Electronic International Standard Serial Number (EISSN)

  • 1365-2265

Digital Object Identifier (DOI)

  • 10.1111/cen.13033

Language

  • eng

Conference Location

  • England