Cited by 273Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesDiabetes Management and Research

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Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986–2006 in Sweden

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Marsk, R., Jonas, E., Rasmussen, F., Näslund, E.·2010·Diabetologia

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Abstract

Aims/hypothesis Symptomatic hypoglycaemia with related confusion, syncope, epilepsy or seizures is a newly recognised complication of gastric bypass surgery for obesity. The incidence of these conditions is not known. We therefore studied the incidence of post-gastric bypass hypoglycaemia and related symptoms in patients who have undergone gastric bypass and a reference cohort from the general population of Sweden.Methods This is a nationwide cohort study based on national registries with 5,040 persons who underwent gastric bypass, vertical banded gastroplasty or gastric banding for obesity in Sweden between 1 January 1986 and 31 December 2006 and a cohort of ten referents per patient matched for sex and age randomly sampled from the general population. The incidence rates of hospitalisation for hypoglycaemia, confusion, syncope, epilepsy or seizures before and after dates of surgery or inclusion in the reference cohort were studied.Results Preoperative incidences of hospitalisation for hypoglycaemia were similar in the surgical and referent cohorts. After gastric bypass surgery, the adjusted hazard ratios were significantly elevated for hypoglycaemia (2.7 [95% CI 1.2-6.3]), confusion (2.8 [1.3-6.0]), syncope (4.9 [3.4-7.0]), epilepsy (3.0 [2.1-4.3]) and seizures (7.3 [5.0-10.8]). The proportions of gastric bypass patients and reference participants affected by hypoglycaemia were very low (0.2% and 0.04%, respectively). There was no increased risk of hypoglycaemia after vertical banded gastroplasty or gastric banding compared with the referent population.Conclusions/interpretation Obese persons who have undergone gastric bypass have an increased risk of hospitalisation for diagnoses associated with post-gastric bypass hypoglycaemia, although few patients are affected.

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Authors: Marsk, R., Jonas, E., Rasmussen, F., & Näslund, E.
Affiliations: Danderyds sjukhus (SE)
Karolinska Institutet (SE)
Corresponding author: Näslund, E.
ORCID: Marsk, R.
Jonas, E.
Rasmussen, F.
Näslund, E.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2010-05-22
Volume: 53
Issue: 11
Pages: 2307-2311
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-010-1798-5
OpenAlex: W2036282220
Cited by: 273
References: 12
Citations by year: 2026: 8 · 2025: 7 · 2024: 10 · 2023: 18 · 2022: 22 · 2021: 18 · 2020: 21 · 2019: 18 · 2018: 20 · 2017: 15 · 2016: 31 · 2015: 20 · 2014: 21 · 2013: 15 · 2012: 12
FWCI: 14.49
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Funders: Karolinska Institutet
Stockholms Läns Landsting
Vetenskapsrådet
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: bariatric surgery, gastric bypass, confusion, syncope, epilepsy, seizures, hospitalization, vertical banded gastroplasty, gastric banding, incidence
MeSH terms: Adult, Confusion, Epilepsy, Female, Humans, Hypoglycemia, Male, Middle Aged, Obesity, Postoperative Complications, Seizures, Syncope, Cohort Studies, Gastric Bypass, Gastroplasty

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Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986–2006 in Sweden

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