Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
Open accessAbstract
BACKGROUND: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. METHODS: Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. RESULTS: Over 11 years of follow-up, 22 patients were identified. The test most used to provoke hypoglycemia was the oral glucose load test followed by the mixed meal test which was the least standardized test. With pharmacological treatment, 3 patients were symptom-free (with octreotide) and in 12 patients hypoglycemic episodes were attenuated. Seven patients had persistent hypoglycemic episodes and underwent surgery. Partial pancreatectomy was performed in 3 patients who had positive selective arterial calcium stimulation, and nesidioblastosis was confirmed in 2 patients. Reconversion to normal anatomy was performed in 3 patients, and 1 patient underwent a resection of the 'candy cane' roux limb, with resolution of hypoglycemia in all cases. CONCLUSIONS: There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not respond to pharmacological treatment, reconstruction of gastrojejunal continuity may be the safest and most successful procedure.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Pancreatic resection, the most commonly reported procedure, was performed in approximately 67% of patients.
“Pancreatic resection, the most commonly reported procedure, was performed in approximately 67% of patients (66,103,105,107,114,116-123).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [66]
The Results (Surgical Treatment) report partial pancreatectomy in 3 patients, while redo surgery was the first surgical option for 4 patients. Thus pancreatic resection accounted for 3 of the 7 surgical cases (about 43%), not approximately 67%, and was not the most common approach in this registry. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredAdministration of nifedipine in combination with verapamil to 10 patients who developed hyperinsulinemic hypoglycemia after bariatric surgery resulted in a partial response in five patients (50%).
“Administration of nifedipine in combination with verapamil to 10 patients who developed hyperinsulinemic hypoglycemia after bariatric surgery resulted in a partial response in five patients (50%) (66).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [66]
The Results (Therapy Strategies: Pharmacological Treatment; page unavailable) report that 10 patients received a calcium-channel blocker—nifedipine or verapamil—and that 50% initially had reduced symptoms. The Discussion describes a partial effect in 50%. The paper does not say the two drugs were administered in combination to those patients, and it reports an initial response rather than an enduring response in all five. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBoth short-acting and long-acting formulations of somatostatin analogues have demonstrated efficacy by slowing gastric emptying, improving hypoglycemia and reducing early and late dumping symptoms.
“Both short-acting and long-acting formulations of somatostatin analogues have demonstrated efficacy by slowing gastric emptying, improving hypoglycemia and reducing early and late dumping symptoms (Table 4) (15,66,(80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [66]
The Results (Therapy Strategies: Pharmacological Treatment; page not provided) report that octreotide reduced or resolved hypoglycemic episodes in some patients. The paper does not establish efficacy for both short- and long-acting formulations, attribute slowed gastric emptying specifically to somatostatin analogues, or report reduced early and late dumping symptoms; the Discussion distinguishes dumping syndrome from the condition studied. (LLM, conf=0.90)
Experimental — accuracy not yet measuredTreatment of six patients who developed hyperinsulinemic hypoglycemia after bariatric surgery with diazoxide (168.7 ± 94 mg/day orally) resulted in a partial response (defined as a 50% reduction in the number and severity of hypoglycemic events) in three patients (50%).
“A recent multicenter, retrospective, systematic case series reported that treatment of six patients who developed hyperinsulinemic hypoglycemia after bariatric surgery with diazoxide (168.7 ± 94 mg/day orally) resulted in a partial response (defined as a 50% reduction in the number and severity of hypoglycemic events) in three patients (50%) (66).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [66]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredVarious surgical re-interventions have been used, including gastric tube placement, gastric bypass reversal with or without concomitant sleeve resection and gastric pouch restriction.
“Various surgical re-interventions have been used, including gastric tube placement, gastric bypass reversal with or without concomitant sleeve resection and gastric pouch restriction (Table 5) (66,103,105-123).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [66]
The Results (Surgical Treatment; page not provided) describe gastric bypass reversal and gastric pouch restriction, and the Discussion mentions nutrition through a gastrostomy tube. The paper does not describe bypass reversal with concomitant sleeve resection; the resection it reports was of a Roux limb, not the stomach. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Approximately 24% of patients who underwent surgical re-intervention because of refractory severe post-Roux-en-Y gastric bypass hypoglycemia received a gastric bypass reversal and approximately 9% had gastric pouch restriction.
“As shown in Table 5, approximately 24% of patients who underwent surgical re-intervention because of refractory severe post-Roux-en-Y gastric bypass hypoglycemia received a gastric bypass reversal (66,103,106-113) and approximately 9% had gastric pouch restriction (66,114,115).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [66]
The Results (Surgical Treatment; page not available) report gastric bypass reversal in three patients and gastric pouch restriction in one patient after RYGB. The paper supports the inclusion of those procedures in the citing authors’ Table 5, but it does not establish the table’s aggregate figures of approximately 24% and 9%. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery.
Service, G. J., Thompson, G. B., Service, F. J., Andrews, J. C., Collazo-Clavell, M. L., & Lloyd, R. V. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043690 · Cited by 779 · see citing works
Goldfine, A. B., Mun, E. C., Devine, E., Bernier, R., Baz-Hecht, M., Jones, D. B., Schneider, B. E., Holst, J. J., & Patti, M. E. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0918 · Cited by 377 · see citing works
Patti, M. E., McMahon, G., Mun, E. C., Bitton, A., Holst, J. J., Goldsmith, J., Hanto, D. W., Callery, M., Arky, R., Nose, V., et al. (2005) · Diabetologia · doi:10.1007/s00125-005-1933-x · Cited by 365 · see citing works
Salehi, M., Prigeon, R. L., & D’Alessio, D. A. (2011) · Diabetes · doi:10.2337/db11-0203 · Cited by 323 · see citing works
Marsk, R., Jonas, E., Rasmussen, F., & Näslund, E. (2010) · Diabetologia · doi:10.1007/s00125-010-1798-5 · Cited by 273 · see citing works
Meier, J. J., Butler, A. E., Galasso, R., & Butler, P. C. (2006) · Diabetes Care · doi:10.2337/dc06-0392 · Cited by 249 · see citing works
McLaughlin, T., Peck, M., Holst, J., & Deacon, C. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1628 · Cited by 183 · see citing works
The Diagnosis of Postprandial Hypoglycemia
Lev-Ran, A., & Anderson, R. W. (1981) · Diabetes · doi:10.2337/diab.30.12.996 · Cited by 148 · see citing works
Kefurt, R., Langer, F., Schindler, K., Shakeri-Leidenmühler, S., Ludvik, B., & Prager, G. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2014.11.003 · Cited by 143 · see citing works
Moreira, R. O., Moreira, R., Machado, N., Gonçalves, T. B., & Coutinho, W. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9569-9 · Cited by 136 · see citing works
Severe Recurrent Hypoglycemia after Gastric Bypass Surgery
Z’graggen, K., Guweidhi, A., Steffen, R., Potoczna, N., Biral, R., Walther, F., Komminoth, P., & Horber, F. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9480-4 · Cited by 125 · see citing works
Won, J. G., Tseng, H.-S., Yang, A.-H., Tang, K.-T., Jap, T., Lee, C.-H., Lin, H.-D., Burcus, N. I., Pittenger, G., & Vinik, A. (2006) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2006.02629.x · Cited by 95 · see citing works
Vidal, J., Nicolau, J., Romero, F., Casamitjana, R., Momblan, D., Conget, I., Morínigo, R., & Lacy, A. M. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1620 · Cited by 94 · see citing works
Hypoglycemia after Roux-en-Y Gastric Bypass: The BOLD Experience
Sarwar, H., Chapman, W. H. I., Pender, J., Ivanescu, A., Drake, A. J. I., Pories, W., & Dar, M. (2014) · Obesity Surgery · doi:10.1007/s11695-014-1260-8 · Cited by 87 · see citing works
Rabiee, A., Magruder, J., Salas-Carrillo, R., Carlson, O., Egan, J. M., Askin, F., Elahi, D., & Andersen, D. K. (2010) · Journal of Surgical Research · doi:10.1016/j.jss.2010.09.047 · Cited by 85 · see citing works
Successful Medical Management of Status Post-Roux-en-Y-Gastric-Bypass Hyperinsulinemic Hypoglycemia
Spanakis, E., & Gragnoli, C. (2009) · Obesity Surgery · doi:10.1007/s11695-009-9888-5 · Cited by 83 · see citing works
Continuous Glucose Monitoring for Evaluation of Glycemic Excursions after Gastric Bypass
Halperin, F., Patti, M., Skow, M., Bajwa, M., & Goldfine, A. (2011) · Journal of Obesity · doi:10.1155/2011/869536 · Cited by 82 · see citing works
Myint, K. S., Greenfield, J. R., Farooqi, I. S., Henning, E., Holst, J. J., & Finer, N. (2012) · European Journal of Endocrinology · doi:10.1530/eje-11-1065 · Cited by 77 · see citing works
Maternal and Perinatal Outcomes After Bariatric Surgery: a Spanish Multicenter Study
González, I., Rubio, M. Á., Cordido, F., Lesmes, I. B., Morales, M. J., Vilarrasa, N., Monereo, S., Lecube, A., Caixàs, A., Vinagre, I., et al. (2014) · Obesity Surgery · doi:10.1007/s11695-014-1387-7 · Cited by 72 · see citing works
Self-citationHypoglycemia After Gastric Bypass: The Dark Side of GLP-1
Patti, M., & Goldfine, A. B. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.01.038 · Cited by 67 · see citing works
Cui, Y., Elahi, D., & Andersen, D. K. (2011) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-011-1585-8 · Cited by 66 · see citing works
Hormonal Response to a Mixed-Meal Challenge After Reversal of Gastric Bypass for Hypoglycemia
Lee, C. J., Brown, T., Magnuson, T. H., Egan, J. M., Carlson, O., & Elahi, D. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1151 · Cited by 65 · see citing works
Patti, M., Li, P., & Goldfine, A. B. (2015) · Obesity · doi:10.1002/oby.21043 · Cited by 62 · see citing works
Kim, S. H., Liu, T. C., Abbasi, F., Lamendola, C. A., Morton, J. M., Reaven, G. M., & McLaughlin, T. (2009) · Obesity Surgery · doi:10.1007/s11695-009-9893-8 · Cited by 62 · see citing works
Management of postgastric bypass noninsulinoma pancreatogenous hypoglycemia
Mathavan, V. K., Arregui, M., Davis, C., Singh, K., Patel, A., & Meacham, J. (2010) · Surgical Endoscopy · doi:10.1007/s00464-010-1001-6 · Cited by 61 · see citing works
Ceppa, E., Ceppa, D., Omotosho, P., Dickerson, J. A., Park, C. W., & Portenier, D. (2012) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2011.08.008 · Cited by 58 · see citing works
Permutt, M. A. (1976) · Diabetes · doi:10.2337/diab.25.8.719 · Cited by 58 · see citing works
González-González, A., Delgado, M., & Fraga-Fuentes, M. (2013) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2011.05.010 · Cited by 50 · see citing works
Hypoglycaemia following gastric bypass surgery—diabetes remission in the extreme?
Patti, M., & Goldfine, A. B. (2010) · Diabetologia · doi:10.1007/s00125-010-1884-8 · Cited by 47 · see citing works
Pigeyre, M., Vaurs, C., Raverdy, V., Hanaire, H., Ritz, P., & Pattou, F. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2014.12.004 · Cited by 40 · see citing works
Successful Treatment of Persistent Hyperinsulinemic Hypoglycemia with Nifedipine in an Adult Patient
Guseva, N., Phillips, D., & Mordes, J. P. (2010) · Endocrine Practice · doi:10.4158/ep09110.crr · Cited by 35 · see citing works
Padoin, A. V., Neto, M. G., Moretto, M., Barancelli, F. T., Schroer, C. E., & Mottin, C. C. (2009) · Obesity Surgery · doi:10.1007/s11695-009-9943-2 · Cited by 34 · see citing works
Mordes, J., & Alonso, L. C. (2015) · Endocrine Practice · doi:10.4158/ep14118.or · Cited by 23 · see citing works
Post-gastric-bypass hypoglycemia successfully treated with alpha-glucosidase inhibitor therapy.
Frankhouser, S. Y., Ahmad, A., Perilli, G., Quintana, B., & Vengrove, M. (2013) · Endocrine Practice · doi:10.4158/ep12281.ra · Cited by 21 · see citing works
Group for the Study of Obesity of the Spanish Endocrinology and Nutrition Society (SEEN), Caixàs, A., Lecube, A., Morales, M.-J., Calañas, A., Moreiro, J., Cordido, F., Díaz, M.-J., Masmiquel, L., Moreno, B., et al. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0791-0 · Cited by 20 · see citing works
Self-citationEffect of calcium antagonists on reactive hypoglycemia associated with hyperinsulinemia
Sanke, T., Nanjo, K., Kondo, M., Nishi, M., Moriyama, Y., & Miyamura, K. (1986) · Metabolism · doi:10.1016/0026-0495(86)90055-7 · Cited by 17 · see citing works
Case report subtotal pancreatectomy as treatment for severe hypoglycemia after gastric bypass
Bray, B. F. G., Peromingo, R., Galindo, J., Arrieta, F., Sánchez, J. C. F., Vázquez, C., & Botella-Carretero, J. I. (2014) · Endocrinología y Nutrición (English Edition) · doi:10.1016/j.endoen.2014.06.016 · Cited by 6 · see citing works
García, B. F., Peromingo, R., Galindo, J., Arrieta, F., Sánchez, J. F., Vázquez, C., & Botella-Carretero, J. I. (2014) · Endocrinologia y Nutricion · doi:10.1016/j.endonu.2014.04.001 · Cited by 2 · see citing works
Hypoglycemia after Roux-en-Y gastric bypass surgery
Molina, M., García, J., Civera, M., Ortega, J., Martínez-Valls, J. F., Martínez‐Hervás, S., Real, J. T., & Carmena, R. (2011) · Endocrinología y Nutrición (English Edition) · doi:10.1016/s2173-5093(11)70044-7 · Cited by 2 · see citing works
Hipoglucemia tras derivación gástrica en Y de Roux
Molina, M., García, J., Civera, M., Ortega, J., Martínez-Valls, J. F., Martínez‐Hervás, S., Real, J. T., & Carmena, R. (2011) · Endocrinología y Nutrición · doi:10.1016/j.endonu.2010.10.012 · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 41 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [3]Service GJ Thompson GB Service FJ Andrews JC Collazo-Clavell ML Lloyd RV Hyperinsulinemic hypoglycaemia with nesiodioblastosis after gastric-bypass surgery N Engl J Med 2005 353 249 254 16034010
- [28]Guseva N Phillips D Mordes JP Successful treatment of persisenthyperinsulinemic hypoglycaemia with nifedipine in an adult patient Endocr Pract 2010 16 107 111 19625246 PMC3979460
Cited by
Sorted by citations
Mechanick, J. I., Youdim, A., Jones, D. B., Garvey, W. T., Hurley, D. L., McMahon, M. M., Heinberg, L. J., Kushner, R., Adams, T. D., Shikora, S., et al. (2013) · Obesity · doi:10.1002/oby.20461 · Cited by 1,650 · see citing works
Mechanisms of action of glucagon-like peptide 1 in the pancreas
Doyle, M. E., & Egan, J. M. (2006) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2006.11.007 · Cited by 679 · see citing works
Jensen, R. T., Cadiot, G., Brandi, M. L., de Herder, W. W., Kaltsas, G., Komminoth, P., Scoazec, J., Salazar, R., Sauvanet, A., & Kianmanesh, R. (2012) · Neuroendocrinology · doi:10.1159/000335591 · Cited by 615 · see citing works
The role of gut hormones in glucose homeostasis
Drucker, D. J. (2007) · Journal of Clinical Investigation · doi:10.1172/jci30076 · Cited by 611 · see citing works
Graaf, C. D., Donnelly, D., Wootten, D., Lau, J., Sexton, P. M., Miller, L. J., Ahn, J.-M., Liao, J., Fletcher, M. M., Yang, D., et al. (2016) · Pharmacological Reviews · doi:10.1124/pr.115.011395 · Cited by 403 · see citing works
Mechanick, J. I., Youdim, A., Jones, D. B., Garvey, W. T., Hurley, D. L., McMahon, M. M., Heinberg, L. J., Kushner, R., Adams, T. D., Shikora, S., et al. (2013) · Endocrine Practice · doi:10.4158/ep12437.gl · Cited by 395 · see citing works
Gastrointestinal hormones regulating appetite
Chaudhri, O. B., Small, C. J., & Bloom, S. R. (2006) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2006.1856 · Cited by 347 · see citing works
International consensus on the diagnosis and management of dumping syndrome
Scarpellini, E., Arts, J., Karamanolis, G., Laurenius, A., Siquini, W., Suzuki, H., Ukleja, A., van Beek, A. V., Vanuytsel, T., Bor, S., et al. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-0357-5 · Cited by 247 · see citing works
Blockade of Glucagon-like Peptide 1 Receptor Corrects Postprandial Hypoglycemia After Gastric Bypass
Salehi, M., Gastaldelli, A., & D'Alessio, D. A. (2014) · Gastroenterology · doi:10.1053/j.gastro.2013.11.044 · Cited by 289 · see citing works
van Beek, A. P., Emous, M., Laville, M., & Tack, J. (2017) · Obesity Reviews · doi:10.1111/obr.12467 · Cited by 288 · see citing works
“Administration of nifedipine in combination with verapamil to 10 patients who developed hyperinsulinemic hypoglycemia after bariatric surgery resulted in a partial response in five patients (50%) (66).”
BackgroundInfluentialElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s008 · Cited by 244 · see citing works
Hypoglycemia After Gastric Bypass Surgery: Current Concepts and Controversies
Salehi, M., Vella, A., McLaughlin, T., & Patti, M.-E. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-00528 · Cited by 239 · see citing works
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s008 · Cited by 213 · see citing works
Khatua, B., El-Kurdi, B., & Singh, V. P. (2017) · Current Opinion in Gastroenterology · doi:10.1097/mog.0000000000000386 · Cited by 210 · see citing works
Hofsø, D., Nordstrand, N., Johnson, L. K., Karlsen, T., Hager, H. B., Jenssen, T. G., Bollerslev, J., Godang, K., Sandbu, R., Røislien, J., et al. (2010) · European Journal of Endocrinology · doi:10.1530/eje-10-0514 · Cited by 207 · see citing works
Summit, O. B. O. T. D. O. T. 2. D. S., Rubino, F., Nathan, D. M., Eckel, R. H., Schauer, P. R., Alberti, K. G. M. M., Zimmet, P., Prato, S. D., Ji, L., SADIKOT, S. M., et al. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2457-9 · Cited by 187 · see citing works
Mineral Malnutrition Following Bariatric Surgery
Gletsu-Miller, N. A., & Wright, B. N. (2013) · Advances in Nutrition · doi:10.3945/an.113.004341 · Cited by 184 · see citing works
Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review
Abdeen, G., & le Roux, C. (2016) · Obesity Surgery · doi:10.1007/s11695-015-1945-7 · Cited by 162 · see citing works
Lee, C. J., Clark, J. M., Schweitzer, M., Magnuson, T., Steele, K., Koerner, O., & Brown, T. T. (2015) · Obesity · doi:10.1002/oby.21042 · Cited by 159 · see citing works
Laparoscopic treatment of type 2 diabetes mellitus for patients with a body mass index less than 35
DePaula, A. L., Macedo, A. L. V., Rassi, N., Machado, C. A., Schraibman, V., Silva, L. Q., & Halpern, A. (2007) · Surgical Endoscopy · doi:10.1007/s00464-007-9472-9 · Cited by 153 · see citing works
Role of the bypassed proximal intestine in the anti-diabetic effects of bariatric surgery
Cummings, D. E., Overduin, J., Foster-Schubert, K. E., & Carlson, M. J. (2007) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2007.02.003 · Cited by 140 · see citing works
Clancy, T. E., Moore, F. D., & Zinner, M. J. (2006) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2006.04.008 · Cited by 133 · see citing works
Critical role for GLP-1 in symptomatic post-bariatric hypoglycaemia
Craig, C. M., Liu, L.-F., Deacon, C., Holst, J., & McLaughlin, T. (2016) · Diabetologia · doi:10.1007/s00125-016-4179-x · Cited by 114 · see citing works
The Effects of Bariatric Surgery on Islet Function, Insulin Secretion, and Glucose Control
Douros, J. D., Tong, J., & D’Alessio, D. A. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00183 · Cited by 98 · see citing works
Medical Nutrition Therapy for Post-Bariatric Hypoglycemia: Practical Insights
Suhl, E., Anderson-Haynes, S.-E., Mulla, C., & Patti, M.-E. (2017) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2017.01.025 · Cited by 96 · see citing works
Benchmarking Best Practices in Weight Loss Surgery
Lim, L., Blackburn, G., & Jones, D. B. (2010) · Current problems in surgery · doi:10.1067/j.cpsurg.2009.11.003 · Cited by 84 · see citing works
Incretin Effects on β-Cell Function, Replication, and Mass
Garber, A. J. (2011) · Diabetes Care · doi:10.2337/dc11-s230 · Cited by 92 · see citing works
Medical management of patients after bariatric surgery: Principles and guidelines
Elrazek, A. E. A., Elbanna, A., & Bilasy, S. E. (2014) · World Journal of Gastrointestinal Surgery · doi:10.4240/wjgs.v6.i11.220 · Cited by 86 · see citing works
Jalleh, R. J., Jones, K. L., Rayner, C. K., Marathe, C. S., Wu, T., & Horowitz, M. (2022) · Diabetologia · doi:10.1007/s00125-022-05796-1 · Cited by 87 · see citing works
Recognition and management of hyperinsulinemic hypoglycemia after bariatric surgery
Malik, S., Mitchell, J., Steffen, K., Engel, S., Wiisanen, R., Garcia, L., & Malik, S. (2015) · Obesity Research and Clinical Practice · doi:10.1016/j.orcp.2015.07.003 · Cited by 80 · see citing works
Strader, A. D., Clausen, T. R., Goodin, S., & Wendt, D. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9754-x · Cited by 86 · see citing works
Alexandrides, T. K., Skroubis, G., & Kalfarentzos, F. E. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9044-z · Cited by 85 · see citing works
Thompson, S. M., Vella, A., Thompson, G. B., Rumilla, K. M., Service, F. J., Grant, C. S., & Andrews, J. C. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2404 · Cited by 80 · see citing works
Bariatric surgery and diabetes remission: Sleeve gastrectomy or mini-gastric bypass?
Milone, M. (2013) · World Journal of Gastroenterology · doi:10.3748/wjg.v19.i39.6590 · Cited by 80 · see citing works
Hyperinsulinemic Hypoglycemia Developing Late after Gastric Bypass
Bantle, J., Ikramuddin, S., Kellogg, T., & Buchwald, H. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9102-6 · Cited by 79 · see citing works
Innovative imaging of insulinoma: the end of sampling? A review
Christ, E., Antwi, K., Fani, M., & Wild, D. (2020) · Endocrine-Related Cancer · doi:10.1530/erc-19-0476 · Cited by 78 · see citing works
Rheinwalt, K. P., Plamper, A., Rückbeil, M. V., Kroh, A., Neumann, U. P., & Ulmer, T. F. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04250-3 · Cited by 78 · see citing works
Lee, C. J., Wood, G., Lazo, M., Brown, T. T., Clark, J. M., Still, C., & Benotti, P. (2016) · Obesity · doi:10.1002/oby.21479 · Cited by 67 · see citing works
Craig, C. M., Lawler, H. M., Lee, C. J. E., Tan, M., Davis, D. B., Tong, J., Glodowski, M., Rogowitz, E., Karaman, R., McLaughlin, T. L., et al. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab103 · Cited by 69 · see citing works
Mediators of Amylin Action in Metabolic Control
Boyle, C. N., Zheng, Y., & Lutz, T. A. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11082207 · Cited by 68 · see citing works
Short-, Mid- and Long-Term Results of Larrad Biliopancreatic Diversion
Larrad-Jiménez, Á., Sánchez-Cabezudo Díaz-Guerra, C., de Cuadros Borrajo, P., Bretón Lesmes, I., & Moreno Esteban, B. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9035-0 · Cited by 67 · see citing works
Hypoglycemia After Gastric Bypass: The Dark Side of GLP-1
Patti, M., & Goldfine, A. B. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.01.038 · Cited by 67 · see citing works
Cui, Y., Elahi, D., & Andersen, D. K. (2011) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-011-1585-8 · Cited by 66 · see citing works
The Change in the Dumping Syndrome Concept
Deitel, M. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9756-8 · Cited by 65 · see citing works
Hyperinsulinemic Hypoglycemia – The Molecular Mechanisms
Nessa, A., Rahman, S. A., & Hussain, K. (2016) · Frontiers in Endocrinology · doi:10.3389/fendo.2016.00029 · Cited by 66 · see citing works
Best Practice Updates for Multidisciplinary Care in Weight Loss Surgery
Apovian, C. M., Cummings, S., Anderson, W., Borud, L. J., Boyer, K., Day, K., Hatchigian, E., Hodges, B., Patti, M., Pettus, M., et al. (2009) · Obesity · doi:10.1038/oby.2008.580 · Cited by 65 · see citing works
Meier, J., Nauck, M., & Butler, P. (2006) · Diabetologia · doi:10.1007/s00125-005-0114-2 · Cited by 66 · see citing works
Patti, M., Li, P., & Goldfine, A. B. (2015) · Obesity · doi:10.1002/oby.21043 · Cited by 62 · see citing works
Bellin, M. D., Parazzoli, S. D., Oseid, E. A., Bogachus, L. D., Schuetz, C., Patti, M., Dunn, T. B., Pruett, T. L., Balamurugan, A. N., Hering, B. J., et al. (2014) · American Journal of Transplantation · doi:10.1111/ajt.12776 · Cited by 61 · see citing works
Alvarez, G. C., Faria, E. N., Beck, M., Girardon, D. T., & Machado, A. C. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9096-0 · Cited by 61 · see citing works
Palladino, A., Sayed, S. U., Katz, L. E. L., Gallagher, P. R., & León, D. D. D. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1263 · Cited by 61 · see citing works
Endocrine and Metabolic Complications After Bariatric Surgery
Jammah, A. A. (2015) · Saudi Journal of Gastroenterology · doi:10.4103/1319-3767.164183 · Cited by 65 · see citing works
Tharakan, G., Behary, P., Albrechtsen, N. J. W., Chahal, H., Kenkre, J. S., Miras, A. D., Ahmed, A. R., Holst, J. J., Bloom, S. R., & Tan, T. (2017) · European Journal of Endocrinology · doi:10.1530/eje-17-0446 · Cited by 61 · see citing works
Davis, D., Khoraki, J., Ziemelis, M., Sirinvaravong, S., Han, J.-Y., & Campos, G. M. (2018) · Molecular Metabolism · doi:10.1016/j.molmet.2017.12.011 · Cited by 64 · see citing works
Body Mass Index and Outcomes from Pancreatic Resection: a Review and Meta-analysis
Ramsey, A., & Martin, R. C. G. (2011) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-011-1502-1 · Cited by 60 · see citing works
Bariatric surgery and obesity: influence on the incretins
Laferrère, B. (2016) · International Journal of Obesity Supplements · doi:10.1038/ijosup.2016.8 · Cited by 55 · see citing works
Stier, C. K., & Chiappetta, S. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2266-1 · Cited by 51 · see citing works
The treatment of hyperinsulinemic hypoglycaemia in adults: an update
On behalf of NIKE Group, Davi′, M. V., Pia, A., Guarnotta, V., Pizza, G., Colao, A., & Faggiano, A. (2017) · Journal of Endocrinological Investigation · doi:10.1007/s40618-016-0536-3 · Cited by 51 · see citing works
Incidence and Predictors of Hypoglycemia 1 Year After Laparoscopic Sleeve Gastrectomy
Belligoli, A., Sanna, M., Serra, R., Fabris, R., Pra', C. D., Conci, S., Fioretto, P., Prevedello, L., Foletto, M., Vettor, R., et al. (2017) · Obesity Surgery · doi:10.1007/s11695-017-2742-2 · Cited by 47 · see citing works
Novel preparations of glucagon for the prevention and treatment of hypoglycemia
Hawkes, C. P., De Leon, D. D., & Rickels, M. R. (2019) · Current Diabetes Reports · doi:10.1007/s11892-019-1216-4 · Cited by 46 · see citing works
Starke, A., Saddig, C., Kirch, B., Tschahargane, C., & Goretzki, P. (2006) · World Journal of Surgery · doi:10.1007/s00268-005-0543-6 · Cited by 46 · see citing works
Glycemic Patterns Are Distinct in Post-Bariatric Hypoglycemia After Gastric Bypass (PBH-RYGB)
Lee, D., Dreyfuss, J. M., Sheehan, A., Puleio, A., Mulla, C. M., & Patti, M. E. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab323 · Cited by 45 · see citing works
Anti-incretin, Anti-proliferative Action of Dopamine on β-Cells
Maffei, A., Segal, A. M., Álvarez-Pérez, J. C., Garcı́a-Ocaña, A., & Harris, P. E. (2015) · Molecular Endocrinology · doi:10.1210/me.2014-1273 · Cited by 47 · see citing works
Mulla, C., Zavitsanou, S., Sanz, A. L. L., Pober, D. M., Richardson, L., Walcott, P., Arora, I., Newswanger, B., Cummins, M. J., Prestrelski, S., et al. (2019) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/clinem/dgz197 · Cited by 24 · see citing works
Preoperative localization of an insulinoma: selective arterial calcium stimulation test performance
Morera, J., Guillaume, A., Courtheoux, P., Palazzo, L., Rod, A., Joubert, M., & Reznik, Y. (2015) · Journal of Endocrinological Investigation · doi:10.1007/s40618-015-0406-4 · Cited by 41 · see citing works
Somatostatin analogues for the treatment of hyperinsulinaemic hypoglycaemia
Haris, B., Saraswathi, S., & Hussain, K. (2020) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018820965068 · Cited by 41 · see citing works
Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients
Andrade, H. F. D. A., Pedrosa, W., Diniz, M. D. F. H. S., & Passos, V. M. D. A. (2016) · Archives of Endocrinology and Metabolism · doi:10.1590/2359-3997000000149 · Cited by 41 · see citing works
Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome?
Debédat, J., Amouyal, C., Aron‐Wisnewsky, J., & Clément, K. (2019) · Seminars in Immunopathology · doi:10.1007/s00281-019-00738-3 · Cited by 40 · see citing works
Insulinoma After Bariatric Surgery: Diagnostic Dilemma and Therapeutic Approaches
Mulla, C. M., Storino, A., Yee, E. U., Lautz, D., Sawnhey, M. S., Moser, A. J., & Patti, M.-E. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2092-5 · Cited by 40 · see citing works
Sheehan, A., & Patti, M. E. (2020) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s233078 · Cited by 39 · see citing works
How common is hypoglycemia after gastric bypass?
Goldfine, A. B., & Patti, M. (2016) · Obesity · doi:10.1002/oby.21520 · Cited by 38 · see citing works
Hazlehurst, J., Khoo, B. C. E., Lobato, C. B., Ilesanmi, I., Abbott, S., Chan, T. L., Pillai, S., Maslin, K., Purkayastha, S., McGowan, B. M., et al. (2024) · Endocrine Connections · doi:10.1530/ec-23-0285 · Cited by 43 · see citing works
Gastroparesis and Dumping Syndrome: Current Concepts and Management
Vavricka, S. R., & Greuter, T. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8081127 · Cited by 37 · see citing works
Fischer, L. E., Wolfe, B. M., Fino, N., Elman, M. R., Flum, D. R., Mitchell, J. E., Pomp, A., Pories, W. J., Purnell, J. Q., Patti, M.-E., et al. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.04.021 · Cited by 36 · see citing works
Akalestou, E., Suba, K., López–Noriega, L., Georgiadou, E., CHABOSSEAU, P. L., Gallie, A., Wretlind, A., Legido‐Quigley, C., Leclerc, I., Salem, V., et al. (2021) · Nature Communications · doi:10.1038/s41467-021-25423-8 · Cited by 33 · see citing works
Hypoglycemia Following Bariatric Surgery: Our 31-Year Experience
Michaels, A. D., Mehaffey, J. H., French, W. B., Schirmer, B. D., Kirby, J. L., & Hallowell, P. T. (2017) · Obesity Surgery · doi:10.1007/s11695-017-2734-2 · Cited by 34 · see citing works
Sanz, A. J. L., Mulla, C. M., Fowler, K. M., Cloutier, E., Goldfine, A. B., Newswanger, B., Cummins, M. J., Deshpande, S., Prestrelski, S. J., Strange, P., et al. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2017.0298 · Cited by 34 · see citing works
Frequency of Hypoglycaemia after Different Bariatric Surgical Procedures
Brix, J., Kopp, H., Höllerl, F., Schernthaner, G., Ludvik, B., & Schernthaner, G. (2019) · Obesity Facts · doi:10.1159/000493735 · Cited by 31 · see citing works
Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea
Woo, C.-Y., Jeong, J. Y., Jang, J. E., Leem, J., Jung, C. H., Koh, E. H., Lee, W. J., Kim, M.-S., Park, J.-Y., Lee, J. B., et al. (2015) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2015.39.2.126 · Cited by 32 · see citing works
Arrieta, F., Iglesias, P., Pedro‐Botet, J., Tébar, F. J., Ortega, E., Nubiola, A., Pardo, J. L., Maldonado, G. F., Obaya, J. C., Matute, P., et al. (2015) · Atención Primaria · doi:10.1016/j.aprim.2015.05.002 · Cited by 32 · see citing works
Postbariatric surgery hypoglycemia: Nutritional, pharmacological and surgical perspectives
Rossini, G., Risi, R., Monte, L., Sancetta, B. M., Quadrini, M., Ugoccioni, M., Masi, D., Rossetti, R., D’Alessio, R., Mazzilli, R., et al. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3750 · Cited by 34 · see citing works
Kassem, M., Durda, M., Stoicea, N., Cavus, O., Sahin, L., & Rogers, B. (2017) · Frontiers in Endocrinology · doi:10.3389/fendo.2017.00037 · Cited by 30 · see citing works
Postprandial hypoglycaemia after Roux-en-Y gastric bypass in individuals with type 2 diabetes
Guarino, D., Moriconi, D., Mari, A., Rebelos, E., Colligiani, D., Baldi, S., Anselmino, M., Ferrannini, E., & Nannipieri, M. (2018) · Diabetologia · doi:10.1007/s00125-018-4737-5 · Cited by 29 · see citing works
Fleming, A., & Rosenberg, L. C. (2007) · Journal of Diabetes Science and Technology · doi:10.1177/193229680700100214 · Cited by 29 · see citing works
Poljo, A., Pentsch, A., Raab, S., Klugsberger, B., & Shamiyeh, A. (2021) · Journal of Metabolic and Bariatric Surgery · doi:10.17476/jmbs.2021.10.1.23 · Cited by 28 · see citing works
Nichols, C. G., York, N., & Remedi, M. S. (2022) · Diabetes · doi:10.2337/db21-0755 · Cited by 31 · see citing works
Autobionics: A New Paradigm in Regenerative Medicine and Surgery
Ashrafian, H., Darzi, A. W., & Athanasiou, T. (2010) · Regenerative Medicine · doi:10.2217/rme.10.2 · Cited by 28 · see citing works
Thompson, S. M., Vella, A. V., Service, F. J., Grant, C. S., Thompson, G. B., & Andrews, J. C. (2015) · Surgery · doi:10.1016/j.surg.2015.03.004 · Cited by 27 · see citing works
Chaudhry, S., Bernardes, M., Harris, P. E., & Maffei, A. (2016) · PubMed · Cited by 27 · see citing works
Garibay, D., Lou, J., Lee, S. A., Zaborska, K. E., Weissman, M. H., Sloma, E. A., Donahue, L. R., Miller, A. D., White, A. C., Michael, M. D., et al. (2018) · Cell Reports · doi:10.1016/j.celrep.2018.03.120 · Cited by 27 · see citing works
Insulin Therapy in Diabetes Mellitus
Bell, D. S. H. (2007) · Drugs · doi:10.2165/00003495-200767130-00002 · Cited by 26 · see citing works
Morano, W. F., Shaikh, M. F., Gleeson, E., Galvez, A., Khalili, M., Lieb, J. G., II, Renza-Stingone, E. P., & Bowne, W. B. (2018) · World Journal of Surgical Oncology · doi:10.1186/s12957-018-1467-6 · Cited by 26 · see citing works
Insulin sensitivity and secretion modifications after bariatric surgery.
Castagneto‐Gissey, L., & Mingrone, G. (2012) · PubMed · doi:10.3275/8470 · Cited by 26 · see citing works
Lembo, E., Lupoli, R., Ciciola, P., Creanza, A., Silvestri, E., Saldalamacchia, G., & Capaldo, B. (2018) · Nutrients · doi:10.3390/nu10060670 · Cited by 25 · see citing works
Bariatric Surgery, Safety and Type 2 Diabetes
Spanakis, E. K., & Gragnoli, C. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9687-4 · Cited by 25 · see citing works
Bantle, A., Wang, Q., & Bantle, J. P. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-1283 · Cited by 23 · see citing works
HIMPENS, J. M., Vilallonga, R., Cadière, G.-B., & Leman, G. (2015) · Surgical Endoscopy · doi:10.1007/s00464-015-4581-3 · Cited by 23 · see citing works
Post–Gastric Bypass Hypoglycemia
Rariy, C. M., Rometo, D. A., & Korytkowski, M. T. (2016) · Current Diabetes Reports · doi:10.1007/s11892-015-0711-5 · Cited by 23 · see citing works
Zhang, S., Guo, W., Wu, J., Gong, L., Li, Q., Xiao, X., Zhang, J., & Wang, Z. (2017) · Medical Science Monitor · doi:10.12659/msm.902230 · Cited by 23 · see citing works
Zhao, K., Patel, N., Kulkarni, K., Gross, J., & Taslakian, B. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103091 · Cited by 22 · see citing works
- Authors
- Vilarrasa, N., Goday, A., Rubio, M. A., Caixàs, A., Pellitero, S., Ciudin, A., Calañas, A., Botella, J. I., Bretón, I., Morales, M. J., Díaz-Fernández, M. J., García-Luna, P. P., & Lecube, A.
- Affiliations
- Bellvitge University Hospital (ES)
- Hospital del Mar Research Institute (ES)
- Hospital Del Mar (ES)
- Universitat Autònoma de Barcelona (ES)
- Venue
- Obesity Facts
- Publisher
- S. Karger AG
- Published
- 2016
- Volume
- 9
- Issue
- 1
- Pages
- 41-51
- ISSN
- 1662-4025 (ISSN-L)
- 1662-4033
- PMC
- PMC5644871
- OpenAlex
- W2276159333
- Cited by
- 197
- References
- 41
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 12 · 2023: 16 · 2022: 15 · 2021: 11 · 2020: 10 · 2019: 15 · 2018: 10 · 2017: 13 · 2016: 24 · 2015: 19 · 2014: 6 · 2013: 6 · 2012: 4
- FWCI
- 22.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Obesity Facts (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion, cc-by-nc)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (publishedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- hyperinsulinemic hypoglycemia, bariatric surgery complications, postprandial hypoglycemia, oral glucose tolerance test, mixed meal tolerance test, octreotide, partial pancreatectomy, nesidioblastosis, Roux-en-Y gastric bypass
- MeSH terms
- Adult, Female, Glucose Tolerance Test, Humans, Hyperinsulinism, Hypoglycemia, Jejunum, Male, Middle Aged, Pancreatectomy, Registries, Retrospective Studies, Spain, Stomach, Octreotide, Incidence, Nesidioblastosis, Bariatric Surgery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
