The incidence and risk factors associated with developing symptoms of hypoglycemia after bariatric surgery
Abstract
Background Hypoglycemia after bariatric surgery is an increasingly recognized metabolic complication associated with exaggerated secretion of insulin and gut hormones.Objective We sought to determine the incidence of hypoglycemic symptoms (hypo-sx) after bariatric surgery and characteristics of those affected compared with those unaffected.Setting University hospital.Methods We collected retrospective survey data from the patients who underwent bariatric surgery at a single center. Based on number and severity of postprandial hypo-sx in Edinburgh hypoglycemia questionnaire postoperatively, patients without preoperative hypo-sx were grouped into high versus low suspicion for hypoglycemia. We used multivariable logistic regression to examine potential baseline and operative risk factors for the development of hypo-sx after surgery.Results Among the 1119 patients who had undergone bariatric surgery who received the questionnaire, 464 (40.6%) responded. Among the 341 respondents without preexisting hypo-sx, 29% (n = 99) had new-onset hypo-sx, and most were severe cases (n = 92) with neuroglycopenic symptoms. Compared with the low suspicion group, the high suspicion group consisted of more female patients, younger patients, patients without diabetes, and those who underwent Roux-en-Y gastric bypass with a longer time since surgery and more weight loss. In multivariate analysis, factors independently associated with incidence of hypo-sx after bariatric surgery were female sex (P = .003), Roux-en-Y gastric bypass (P = .001), and absence of preexisting diabetes (P = .011).Conclusions New onset postprandial hypoglycemic symptoms after bariatric surgery are common, affecting up to a third of those who underwent bariatric surgery. Many affected individuals reported neuroglycopenic symptoms and were more likely to be female and nondiabetic and to have undergone Roux-en-Y gastric bypass.
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People with obesity who underwent Roux-en-Y gastric bypass are more affected by postprandial hypoglycemia than individuals who have undergone a sleeve gastrectomy.
“People with obesity who underwent Roux-en-Y gastric bypass are more affected than individuals who have undergone a sleeve gastrectomy.”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [11]
After esophageal, gastric, or bariatric surgery, new onset of postprandial hypoglycemic episodes can occur.
“After esophageal, gastric, or bariatric surgery, new onset of postprandial hypoglycemic episodes can occur.”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [11]
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Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications
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- Authors
- Lee, C. J., Brown, T. T., Schweitzer, M., Magnuson, T., & Clark, J. M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Lee, Clare J.
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 14
- Issue
- 6
- Pages
- 797-802
- ISSN
- 1550-7289 (ISSN-L)
- OpenAlex
- W2785543849
- Cited by
- 49
- References
- 24
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 4 · 2022: 8 · 2021: 10 · 2020: 5 · 2019: 3 · 2018: 1
- FWCI
- 4.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Surgery for Obesity and Related Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Johns Hopkins University
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK107921)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- postprandial hypoglycemia, bariatric surgery
- MeSH terms
- Female, Gastrectomy, Humans, Hypoglycemia, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Risk Factors, Gastric Bypass, Postprandial Period, Diabetes Complications, Bariatric Surgery
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