Digital Solutions to Diagnose and Manage Postbariatric Hypoglycemia
Open accessAbstract
Postbariatric hypoglycemia (PBH) is an increasingly recognized late metabolic complication of bariatric surgery, characterized by low blood glucose levels 1–3 h after a meal, particularly if the meal contains rapid-acting carbohydrates. PBH can often be effectively managed through appropriate nutritional measures, which remain the cornerstone treatment today. However, their implementation in daily life continues to challenge both patients and health care providers. Emerging digital technologies may allow for more informed and improved decision-making through better access to relevant data to manage glucose levels in PBH. Examples include applications for automated food analysis from meal images, digital receipts of purchased food items or integrated platforms allowing the connection of continuously measured glucose with food and other health-related data. The resulting multi-dimensional data can be processed with artificial intelligence systems to develop prediction algorithms and decision support systems with the aim of improving glucose control, safety, and quality of life of PBH patients. Digital innovations, however, face trade-offs between user burden vs. amount and quality of data. Further challenges to their development are regulatory non-compliance regarding data ownership of the platforms acquiring the required data, as well as user privacy concerns and compliance with regulatory requirements. Through navigating these trade-offs, digital solutions could significantly contribute to improving the management of PBH.
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Continuous glucose monitoring systems measure blood glucose levels in real time every 1 to 5 minutes for several consecutive days.
“the use of continuous glucose monitoring (CGM) systems, which measure BG levels in real time every 1 to 5 minutes for several consecutive days, can drastically improve PBH management.7”
From Design and Usability Assessment of a User-Centered, Modular Platform for Real-World Data Acquisition in Clinical Trials Involving Post-Bariatric Surgery Patients (2025) · cites this paper as [7]
The Role of Continuous Glucose Monitoring section says CGM measures interstitial glucose every 5 minutes and enables real-time visualization; it also describes potential benefits for PBH management. It does not establish measurements every 1–5 minutes or for several consecutive days, and interstitial glucose is not the same as direct blood-glucose measurement. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCGM systems combined with a dedicated mobile application can help patients track their blood glucose levels to promptly identify hypoglycemic events, monitor the impact of diet and exercise on metabolism, and receive personalized recommendations.
“In fact, CGM systems, combined with a dedicated mobile application, can help patients tracking their BG levels to promptly identify hypoglycemic events, but also monitor the impact of diet and exercise on the metabolism and receive personalized recommendations.”
From Design and Usability Assessment of a User-Centered, Modular Platform for Real-World Data Acquisition in Clinical Trials Involving Post-Bariatric Surgery Patients (2025) · cites this paper as [7]
The Role of Continuous Glucose Monitoring describes real-time glucose tracking, detection of hypoglycemic events, and using meal-related glucose patterns to guide dietary choices (page not provided). Digital Platforms for Multi-Level Data Integration and Decision Support describes a mobile app combining CGM, meal logs, and activity data. However, personalized recommendations are described for a separate digital-receipts app, not as a function of the CGM-integrated app; the paper also does not establish that this app shows patients the metabolic impact of exercise. (LLM, conf=0.83)
Experimental — accuracy not yet measured
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Abdelgadir, E., Rashid, F., Awadi, F. A. A., Busaidi, N. A., Alfaris, N., Hadad, M. A., Alkaabi, J., Kharusi, A. A., Al-Ozairi, E., Alromaihi, D., et al. (2025) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaf225 · Cited by 3 · see citing works
Cossu, L., Cappon, G., Wortmann, F., Herzig, D., Bally, L., & Facchinetti, A. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1758474 · Cited by 1 · see citing works
Self-citationRole of Myokines and prospects for their role in Diabetes Mellitus Therapy
Nuriya, K., Farida, M., Sharma, R., Liliya, S., Mkhitaryan, X. E., Chergizova, B., Salikhova, Y., Niyazova, Y., Ryspayeva, G., Evnevich, A., et al. (2024) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2024.00786
Wu, J., García, K., Mayer, S., & Albert, J. L. (2026) · Semantic Web · doi:10.1177/22104968261431445
Self-citation
- Authors
- Schönenberger, K. A., Cossu, L., Prendin, F., Cappon, G., Wu, J., Fuchs, K. L., Mayer, S., Herzig, D., Facchinetti, A., & Bally, L.
- Affiliations
- University of Bern (CH)
- University of Padua (IT)
- University of St.Gallen (CH)
- Corresponding author
- Bally, Lia
- ORCID
- Venue
- Frontiers in Nutrition
- Publisher
- Frontiers Media SA
- Published
- 2022-04-07
- Volume
- 9
- Pages
- 855223-855223
- ISSN
- 2296-861X (ISSN-L)
- PMC
- PMC9021863
- OpenAlex
- W4226345303
- Cited by
- 16
- References
- 71
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 5
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by)
- ETH Zürich Research Collection
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- bariatric surgery complications, digital health technologies, continuous glucose monitoring, artificial intelligence prediction, decision support system, glycemic control, data ownership, user privacy, regulatory compliance, dietary management
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