Postoperative surveillance and detection of postprandial hypoglycemia after fundoplasty in children
Open accessAbstract
Objective To evaluate the prevalence of postprandial hypoglycemia (PPH) after fundoplasty after the initiation of a universal postoperative glucose surveillance plan in the neonatal intensive care unit (NICU).Study design This was a retrospective chart review of children (newborn to 18 years) who underwent fundoplasty at The Children's Hospital of Philadelphia during the 2-year-period after the launch of a surveillance protocol in the NICU and other units. The rate of screening, frequency of PPH (postprandial blood glucose <60 mg/dL [3.3 mmol/L] on 2 occasions), frequency of postprandial hyperglycemia preceding PPH, timing of PPH presentation, and related symptoms were evaluated.Results A total of 285 children were included (n = 64 in the NICU; n = 221 in other units). Of the children screened in all units, 24.0% showed evidence of PPH, compared with 1.3% of unscreened children. Hyperglycemia preceded PPH in 67.7% (21/31) of all screened children. Within the NICU, most children had PPH within 1 week, but only 53.3% exhibited symptoms of dumping syndrome.Conclusions This study supports the use of universal postoperative blood glucose surveillance in identifying PPH in children after fundoplasty. Earlier identification of PPH would lead to earlier treatment and minimize the effects of unidentified hypoglycemic events.
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Postprandial hypoglycemia in infants and children is usually a complication of fundoplication for gastroesophageal reflux (incidence 25%-30%) or gastric bypass bariatric surgery for morbid obesity.
“Postprandial hypoglycemia in infants and children is usually a complication of fundoplication for gastroesophageal reflux (incidence 25%−30%) or gastric bypass bariatric surgery for morbid obesity.”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [35]
In patients with postprandial hypoglycemia after fundoplication or gastric bypass, a meal may trigger hypoglycemia 1-3 hours later.
“In these patients, a meal may trigger hypoglycemia 1–3 hours later.”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [35]
Postprandial hypoglycemia is often preceded by exaggerated glucose, glucagon-like peptide-1, and insulin responses, which can be detected on an oral glucose or mixed-meal tolerance test.
“Postprandial hypoglycemia is often preceded by exaggerated glucose, glucagon-like peptide-1, and insulin responses, which can be detected on an oral glucose or mixed-meal tolerance test.35”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [35]
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“Postprandial hypoglycemia is often preceded by exaggerated glucose, glucagon-like peptide-1, and insulin responses, which can be detected on an oral glucose or mixed-meal tolerance test.(35)”
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- Authors
- Calabria, A. C., Gallagher, P. R., Simmons, R., Blinman, T., & De León, D. D.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2011-10
- Volume
- 159
- Issue
- 4
- Pages
- 597-601.e1
- ISSN
- 0022-3476 (ISSN-L)
- PMC
- PMC4489543
- OpenAlex
- W2018819050
- Cited by
- 46
- References
- 17
- Citations by year
- 2025: 2 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 6 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK055704, T32DK063688)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- postprandial hypoglycemia, postprandial hyperglycemia, dumping syndrome, neonatal intensive care unit, pediatric surgery
- MeSH terms
- Adolescent, Blood Glucose, Child, Child, Preschool, Dumping Syndrome, Female, Gastroesophageal Reflux, Humans, Hyperglycemia, Hypoglycemia, Infant, Infant, Newborn, Intensive Care Units, Male, Postoperative Care, Retrospective Studies, Blood Glucose Self-Monitoring, Fundoplication
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