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Cited by 15Bariatric Surgery and OutcomesDiabetes Management and ResearchMinimally Invasive Surgical Techniques

Medical and Surgical Treatment of Postbariatric Hypoglycaemia: Retrospective Data from Daily Practice

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de Heide, Loek J. M., Wouda, Sterre H. T., Peters, Vincent J. T., Oosterwerff‐Suiker, Mirjam, Gerdes, Victor A., Emous, Marloes, van Beek, André P.·2023·Diabetes, Obesity and Metabolism
DOI 10.1111/dom.14920
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Abstract

Aim: To evaluate medical and surgical treatment of postbariatric hypoglycaemia (PBH) in daily practice. Materials and Methods: Retrospective data were extracted from medical records from four hospitals. PBH was defined by neuroglycopenic symptoms together with a documented glucose <3.0 mmol/L in the postprandial setting after previous bariatric surgery. Data were scored semiquantitatively on efficacy and side effects by two reviewers independently. Duration of efficacy and of use were calculated. Results: In total, 120 patients were included with a median follow‐up of 27 months with a mean baseline age of 41 years, total weight loss of 33% and glucose nadir 2.3 mmol/L. Pharmacotherapy consisted of acarbose, diazoxide, short‐ and long‐acting octreotide and glucagon‐like peptide‐1 receptor agonist analogues (liraglutide and semaglutide) with an overall efficacy in 45%‐75% of patients. Combination therapy with two drugs was used by 30 (25%) patients. The addition of a second drug was successful in over half of the patients. Long‐acting octreotide and the glucagon‐like peptide‐1 receptor agonist analogues scored best in terms of efficacy and side effects with a median duration of use of 35 months for octreotide. Finally, 23 (19%) patients were referred for surgical intervention. Efficacy of the surgical procedures, pouch banding, G‐tube placement in remnant stomach and Roux‐en‐Y gastric bypass reversal, pooled together, was 79% with a median duration of initial effect of 13 months. Conclusions: In daily practice, pharmacotherapy for PBH was successful in half to three quarters of patients. Combination therapy was often of value. One in five patients finally needed a surgical procedure, with overall good results.

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Authors
de Heide, L. J. M., Wouda, S. H. T., Peters, V. J. T., Oosterwerff‐Suiker, M., Gerdes, V. A., Emous, M., & van Beek, A. P.
Affiliations
  • Centre for Obesity Northern Netherlands, Department of Surgery Medical Center Leeuwarden Leeuwarden The Netherlands
  • University of Groningen (NL)
  • Tilburg University (NL)
  • Catharina Ziekenhuis (NL)
  • Department of Internal Medicine Spaarne Hospital Hoofddorp The Netherlands
  • Medisch Centrum Leeuwarden (NL)
  • Department of Endocrinology University of Groningen, University Medical Center Groningen Groningen The Netherlands
ORCID
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2022-12-07
Volume
25
Issue
3
Pages
735-747
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
DOI
10.1111/dom.14920
OpenAlex
W4309097941
Cited by
15
References
8
Citations by year
2026: 4 · 2025: 7 · 2024: 2 · 2023: 2
FWCI
2.63
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • Research portal (Tilburg University) (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
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
bariatric surgery complications, pharmacotherapy, acarbose, diazoxide, octreotide, GLP-1 receptor agonists, liraglutide, semaglutide, combination therapy, surgical treatment, gastric banding, gastrostomy tube, remnant stomach, neuroglycopenic symptoms
MeSH terms
Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Adult, Glucose, Humans, Hypoglycemia, Obesity, Morbid, Retrospective Studies, Octreotide, Gastric Bypass

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