Post-Gastric Bypass Hypoglycemia: A Review

Abstract

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 post-bariatric surgery hypoglycemia. 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 post-bariatric surgery hypoglycemia. To date, the pathogenesis of this condition has not been completely established. However, various factors—particularly increased post-prandial 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 hypoglycemia, which typically occurs 1–3 hours after a meal and is concurrent with inappropriate hyperinsulinemia. Carbohydrate-rich foods usually provoke hypoglycemic symptoms, which can typically be alleviated by strict dietary modifications, including carbohydrate restriction and avoidance of high-glycemic-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.

This article is protected by copyright. All rights reserved.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1SFvk2B
via IFTTT