Medical Nutrition Therapy and Other Approaches to Management of Post-bariatric Hypoglycemia: A Team-Based Approach

American Society for Metabolic and Bariatric Surgery. Estimate of Bariatric Surgery Numbers, 2011–2019 | American Society for Metabolic and Bariatric Surgery. @asmbs. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers. Published 2021. Updated 2021–03–08. Accessed 3 Nov 2021.

Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet (London, England). 2015;386(9997):964–73.

Article  Google Scholar 

Purnell JQ, Dewey EN, Laferrère B, et al. Diabetes remission status during seven-year follow-up of the longitudinal assessment of bariatric surgery study. J Clin Endocrinol Metab. 2021;106(3):774–88.

PubMed  Article  Google Scholar 

Roth AE, Thornley CJ, Blackstone RP. Outcomes in bariatric and metabolic surgery: an updated 5-year review. Curr Obes Rep. 2020;9:380–9.

CAS  PubMed  Article  Google Scholar 

Capristo E, Panunzi S, De Gaetano A, et al. Incidence of hypoglycemia after gastric bypass vs sleeve gastrectomy: a randomized trial. J Clin Endocrinol Metab. 2018;103(6):2136–46.

PubMed  Article  Google Scholar 

Lazar LO, Sapojnikov S, Pines G, et al. Symptomatic and asymptomatic hypoglycemia post three different bariatric procedures: a common and severe complication. Endocr Pract. 2019. https://doi.org/10.4158/EP-2019-0185.

Article  PubMed  Google Scholar 

Abrahamsson N, Edén Engström B, Sundbom M, Karlsson FA. Hypoglycemia in everyday life after gastric bypass and duodenal switch. Eur J Endocrinol. 2015;173(1).

• Kubota T, Shoda K, Ushigome E, et al. Utility of continuous glucose monitoring following gastrectomy. Gastric Cancer. 2020;23(4):699–706. This study utilized CGM to show glycemic profiles of patients undergoing gastrectomy. CGM demonstrated nocturnal low sensor glucoses, as well as diurnal glycemic variability, not always associated with early dumping, thus implicating other mechanistic factors. Some participants were asymptomatic during periods of low sensor glucose.

CAS  PubMed  Article  Google Scholar 

Zaloga GP, Chernow B. Postprandial hypoglycemia after Nissen fundoplication for reflux esophagitis. Gastroenterology. 1983;84(4):840–2.

CAS  PubMed  Article  Google Scholar 

Bairdain S, Cleary M, Lien C, Vernon AH, Linden BC, Lautz DB. Laparoscopic adjustable gastric banding and hypoglycemia. Case Rep Endocrinol. 2013;2013:671848.

PubMed  PubMed Central  Google Scholar 

• Fischer LE, Wolfe BM, Fino N, et al. Postbariatric hypoglycemia: symptom patterns and associated risk factors in the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2021;17(10):1787–98. This longitudinal cohort study examined hypoglycemia symptoms following RYGB and laparoscopic adjustable gastric banding. Preoperative symptoms consistent with hypoglycemia, and SSRI/SNRI use in those with no history of diabetes were associated with an increased risk of symptoms after RYGB.

PubMed  Article  Google Scholar 

• Salehi M, Vella A, McLaughlin T, Patti ME. Hypoglycemia after gastric bypass surgery: current concepts and controversies. J Clin Endocrinol Metab. 2018;103(8):2815–26. This review summarizes the pathophysiology, diagnosis, and treatment of PBH.

PubMed  PubMed Central  Article  Google Scholar 

Nguyen NQ, Debreceni TL, Bambrick JE, et al. Rapid gastric and intestinal transit is a major determinant of changes in blood glucose, intestinal hormones, glucose absorption and postprandial symptoms after gastric bypass. Obesity (Silver Spring). 2014;22(9):2003–9.

CAS  Article  Google Scholar 

Salehi M, Gastaldelli A, D’Alessio DA. Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass. Gastroenterology. 2014;146(3):669-680.e662.

CAS  PubMed  Article  Google Scholar 

Dirksen C, Eiken A, Bojsen-Moller KN, et al. No islet cell hyperfunction, but altered gut-islet regulation and postprandial hypoglycemia in glucose-tolerant patients 3 years after gastric bypass surgery. Obes Surg. 2016;26(9):2263–7.

PubMed  Article  Google Scholar 

Patti ME, Goldfine AB. Hypoglycemia after gastric bypass: the dark side of GLP-1. Gastroenterology. 2014;146(3):605–8.

CAS  PubMed  Article  Google Scholar 

Salehi M, Prigeon RL, D’Alessio DA. Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. Diabetes. 2011;60(9):2308–14.

CAS  PubMed  PubMed Central  Article  Google Scholar 

Zhou LY, Deng MQ, Xiao XH. Potential contribution of the gut microbiota to hypoglycemia after gastric bypass surgery. Chin Med J. 2020;133(15):1834–43.

PubMed  PubMed Central  Article  Google Scholar 

Mulla CM, Goldfine AB, Dreyfuss JM, et al. Plasma FGF-19 levels are increased in patients with post-bariatric hypoglycemia. Obes Surg. 2019;29(7):2092–9.

PubMed  PubMed Central  Article  Google Scholar 

Dror E, Dalmas E, Meier DT, et al. Postprandial macrophage-derived IL-1β stimulates insulin, and both synergistically promote glucose disposal and inflammation. Nat Immunol. 2017;18(3):283–92.

CAS  PubMed  Article  Google Scholar 

Abrahamsson N, Börjesson JL, Sundbom M, Wiklund U, Karlsson FA, Eriksson JW. Gastric bypass reduces symptoms and hormonal responses in hypoglycemia. Diabetes. 2016;65(9):2667–75.

CAS  PubMed  Article  Google Scholar 

•• Øhrstrøm CC, Hansen DL, Kielgast UL, et al. Counterregulatory responses to postprandial hypoglycemia after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2021;17(1):55–63. This study evaluated counterregulatory responses during postprandial hypoglycemia in individuals with PBH who underwent RYGB. Only minor increases in counterregulatory hormones were observed at the time of nadir glucose. The authors conclude that recurrent hypoglycemia may alter the glycemic threshold for counterregulatory activation.

PubMed  Article  Google Scholar 

Martín-Timón I, del Cañizo-Gómez FJ. Mechanisms of hypoglycemia unawareness and implications in diabetic patients. World J Diabetes. 2015;6(7):912–26.

PubMed  PubMed Central  Article  Google Scholar 

Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R. Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol. 2009;6(10):583–90.

PubMed  Article  Google Scholar 

Marsk R, Jonas E, Rasmussen F, Näslund E. Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986–2006 in Sweden. Diabetologia. 2010;53(11):2307–11.

CAS  PubMed  Article  Google Scholar 

Lee C, Brown T, Schweitzer M, Magnuson T, Clark J. 389-P: comparison of hormonal response to a mixed-meal challenge in individuals with hypoglycemia after sleeve gastrectomy vs. gastric bypass | Diabetes | American Diabetes Association. Diabetes. 2019;68.

Kellogg TA, Bantle JP, Leslie DB, et al. Postgastric bypass hyperinsulinemic hypoglycemia syndrome: characterization and response to a modified diet. Surg Obes Relat Dis. 2008;4(4):492–9.

PubMed  Article  Google Scholar 

Sarwar H, Chapman WH, Pender JR, et al. Hypoglycemia after Roux-en-Y gastric bypass: the BOLD experience. Obes Surg. 2014;24(7):1120–4.

PubMed  Article  Google Scholar 

Lee CJ, Clark JM, Schweitzer M, Magnuson T, Steele K, Koerner O, Brown TT. Prevalence of and risk factors for hypoglycemic symptoms after gastric bypass and sleeve gastrectomy. Obesity (Silver Spring, Md). 2015;23(5):1079–84.

PubMed Central  Article  Google Scholar 

Kefurt R, Langer FB, Schindler K, Shakeri-Leidenmühler S, Ludvik B, Prager G. Hypoglycemia after Roux-En-Y gastric bypass: detection rates of continuous glucose monitoring (CGM) versus mixed meal test. Surg Obes Relat Dis. 2015;11(3):564–9.

PubMed  Article  Google Scholar 

Whipple AO, Frantz VK. Adenoma of islet cells with hyperinsulinism: a review. Ann Surg. 1935;101(6):1299–335.

CAS  PubMed  PubMed Central  Article  Google Scholar 

Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009;94(3):709–28.

CAS  PubMed  Article  Google Scholar 

Lev-Ran A, Anderson RW. The diagnosis of postprandial hypoglycemia. Diabetes. 1981;30(12):996–9.

CAS  PubMed  Article  Google Scholar 

Singh E, Vella A. Hypoglycemia after gastric bypass surgery. Diabetes Spectr. 2012;25(4):217–21.

CAS  Article  Google Scholar 

Andrade HF, Pedrosa W, Diniz Mde F, Passos VM. Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients. Arch Endocrinol Metab. 2016;60(4):307–13.

PubMed  Article  Google Scholar 

Ravindra S, Shetty S. Insulin autoimmune syndrome: a rare cause of spontaneous hypoglycaemia in non-diabetic individuals. BMJ case reports. 2020;13(12):e234448.

PubMed  Article  Google Scholar 

Mulla CM, Storino A, Yee EU, et al. Insulinoma after bariatric surgery: diagnostic dilemma and therapeutic approaches. Obes Surg. 2016;26(4):874–81.

PubMed  PubMed Central  Article  Google Scholar 

Edwards K, de La Portilla L, Mirza FS, Luthra P. Proinsulin-predominant pancreatic neuroendocrine tumor-induced hypoglycemia after Roux-en-Y gastric bypass surgery. AACE Clin Case Rep. 2019;5(6):e339–43.

PubMed  PubMed Central  Article  Google Scholar 

Garla V, Sonani H, Palabindala V, Gomez-Sanchez C, Subauste J, Lien LF. Non-islet cell hypoglycemia: case series and review of the literature. Front Endocrinol. 2019;10:713–22.

Article  Google Scholar 

• van Furth AM, van den Broek M, Emous M, de Heide LJM, Kuipers F, van Beek AP. Cholecystectomy increases the risk of dumping syndrome and postbariatric hypoglycemia after bariatric surgery. Surg Obes Relat Dis. 2020;16(12):1939–47. This study compared the prevalence of self-reported complaints of DS and PBH in post-bariatric patients with and without cholecystectomy. The risk ratio for PBH was found to be higher after cholecystectomy post-sleeve gastrectomy, potentially related to altered bile acid kinetics.

PubMed  Article  Google Scholar 

Lee CJ, Craig Wood G, Lazo M, et al. Risk of post-gastric bypass surgery hypoglycemia in nondiabetic individuals: a single center experience. Obesity (Silver Spring). 2016;24(6):1342–8.

CAS  Article  Google Scholar 

Rebelos E, Moriconi D, Scalese M, et al. Impact of postprandial hypoglycemia on weight loss after bariatric surgery. Obes Surg. 2020;30(6):2266–73.

PubMed  Article  Google Scholar 

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