Post-bypass hypoglycaemia: A review of current findings
Abstract
Gastric bypass is one of the most efficient strategies for long-term weight loss and reduction of the comorbidities associated with morbid obesity. Of the complications secondary to gastric bypass, hypoglycaemic episodes have so far been poorly studied. The present study is a comprehensive report of the fewer than 100 cases described in the literature. It shows that strict diagnostic criteria should be applied to differentiate true intense neuroglucopenic symptoms associated with low glucose values (<2.8 mmol/L) from the more frequent symptoms of the dumping syndrome and those occurring in the context of lower-than-normal plasma glucose concentrations. The pancreatic beta-cell hyperfunction initially deemed responsible for hypoglycaemic episodes because of frequent islet abnormalities is described and reappraised in this report. The few validated therapeutic options are also discussed.
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Some clinicians consider plasma glucose concentrations <2.8 mmol/L (50 mg/dL) to be indicative of post-gastric bypass hypoglycemia, whereas others regard levels <3.3 mmol/L (60 mg/dL) diagnostic of hypoglycemia.
“To date, no definitive guidance regarding cutoff values for plasma glucose has been established, but some clinicians consider plasma glucose concentrations <2.8 mmol/L (50 mg/dL) to be indicative of post-gastric bypass hypoglycemia, whereas others regard levels <3.3 mmol/L (60 mg/dL) diagnostic of hypoglycemia (33).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [33]
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Background
- Authors
- Ritz, P., & Hanaire, H.
- Affiliations
- Université Toulouse III - Paul Sabatier (FR)
- Centre Hospitalier Universitaire de Toulouse (FR)
- Corresponding author
- Ritz, P.
- ORCID
- Venue
- Diabetes & Metabolism
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 37
- Issue
- 4
- Pages
- 274-281
- ISSN
- 1262-3636 (ISSN-L)
- OpenAlex
- W2026431877
- Cited by
- 56
- References
- 56
- Citations by year
- 2024: 3 · 2023: 1 · 2022: 5 · 2021: 5 · 2020: 6 · 2019: 5 · 2018: 1 · 2017: 2 · 2016: 5 · 2015: 5 · 2014: 7 · 2013: 7 · 2012: 4
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- 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
- gastric bypass, morbid obesity, bariatric surgery complications, dumping syndrome, neuroglycopenic symptoms, Whipple's triad, hypoglycemia treatment
- MeSH terms
- Dumping Syndrome, Humans, Hypoglycemia, Gastric Bypass, Nesidioblastosis
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