Hypoglycemia or Hyperinsulinemia are getting more attention in post-gastric bypass patients. It is turning out to be more common than once thought. Below are the links to studies related to this issue. The link is followed by a snippet from the abstract (summary).
Most of the links go directly to the abstract, rather than the full text. Often times, the full text of a more recent research study requires access to an academic library or to the journal itself. So, if you would like to read more than the abstract, ask your bariatric practitioner or maybe a friend who works at a college to if they would mind getting a copy of the full text for you.
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1) Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass: Unraveling the Role of Gut Hormonal and Pancreatic Endocrine Dysfunction
Profound hypoglycemia occurs rarely as a late complication after Roux-en-Y gastric bypass (RYGB). We investigated the role of glucagon-like-peptide-1 (GLP-1) in four subjects who developed recurrent neuro-glycopenia 2 to 3 y after RYGB._____________________________________________________________
2) Abnormal glucose tolerance testing following gastric bypass demonstrates reactive hypoglycemia
Symptoms of reactive hypoglycemia have been reported by patients after Roux-en-Y gastric bypass (RYGB) surgery who experience maladaptive eating behavior and weight regain. A 4-h glucose tolerance test (GTT) was used to assess the incidence and extent of hypoglycemia.___________________________
3) Glucagon Treatment for Post-Gastric Bypass Hypoglycemia
Hyperinsulinemic hypoglycemia is a rare complication of RYGB; its pathophysiology remains incompletely understood (1,3,4). These patients exhibit inappropriately high insulin and C-peptide concentrations during hypoglycemia (5,6). In addition, exaggerated insulin and incretin responses are observed during mixed meal tolerance test (5) and may contribute to hypoglycemia, potentially mediated in part by islet cell hyperplasia and/or altered function (1,4). Although most cases are mild and managed with dietary modification, symptoms can be profound and result in serious adverse consequences, and clinical management can be challenging. Treatment options include intensive dietary modification (6,7), α-glucosidase inhibitors, octreotide, and diazoxide (5,7). However, some patients remain refractory to treatment, and partial pancreatectomy has been undertaken, with varying success (4). Given the lack of efficacy of available interventions in some patients, and the goal of averting pancreatectomy, additional pharmacologic options are needed.
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4) Advances in the Etiology and Management of Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass Treatment of hypoglycemia after RYGB should begin with strict dietary (low carbohydrate) alteration and may require a trial of diazoxide, octreotide, or calcium-channel antagonists, among other drugs. Surgical therapy should include consideration of a restrictive form of bariatric procedure, with or without reconstitution of gastrointestinal continuity. Partial or total pancreatic resection should be avoided.
4) Advances in the Etiology and Management of Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass Treatment of hypoglycemia after RYGB should begin with strict dietary (low carbohydrate) alteration and may require a trial of diazoxide, octreotide, or calcium-channel antagonists, among other drugs. Surgical therapy should include consideration of a restrictive form of bariatric procedure, with or without reconstitution of gastrointestinal continuity. Partial or total pancreatic resection should be avoided.
