Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
Open accessAbstract
Post-bariatric hypoglycemia (PBH) is an increasingly recognized long-term complication of bariatric surgery. The nutritional treatment of PBH includes a high-fiber diet and the restriction of soluble and high-glycemic index carbohydrates; however, these measures are not always enough to prevent hypoglycemia. We evaluated the efficacy of uncooked cornstarch, a low-glycemic index carbohydrate characterized by slow intestinal degradation and absorption, in addition to a high-fiber diet, for the treatment of PBH. We report the cases of two young women suffering from severe postprandial and fasting hypoglycemia following Roux-en-Y gastric bypass (RYGB). The patients underwent Continuous Glucose Monitoring (CGM) before and 12–16 weeks after the administration of uncooked cornstarch (respectively 1.25 g/kg b.w. and 1.8 g/kg b.w.) in addition to a high-fiber diet. In both patients, CGM showed more stable glucose levels throughout monitoring, a remarkable reduction of the time spent in hypoglycemia (<55 mg/dL) both during the day (−11% for both patients) and the night (−22% and −32%), and the improvement of all glycemic variability indexes. Our report, within the limit of only two cases, suggests that the implementation of a dietary intervention through the addition of uncooked cornstarch reduces daily glycemic fluctuations and hypoglycemic episodes in patients with PBH.
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Uncooked corn starch can be added to meals to try to slow nutrient absorption.
“Uncooked corn starch can be added to meals to try to slow nutrient absorption [56].”
From Non-Diabetic Hypoglycemia: Evaluation and Management in Adults (2025) · cites this paper as [56]
The Introduction describes uncooked cornstarch as slowly degraded and absorbed, and the Discussion says it was added to the patients’ diets. But the paper does not show that adding it to meals slows absorption of other nutrients; its case reports describe doses given in the morning, afternoon, or at bedtime. (LLM, conf=0.86)
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- Authors
- Lembo, E., Lupoli, R., Ciciola, P., Creanza, A., Silvestri, E., Saldalamacchia, G., & Capaldo, B.
- Affiliations
- Federico II University Hospital (IT)
- University of Naples Federico II (IT)
- Corresponding author
- Capaldo, Brunella
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2018-05-25
- Volume
- 10
- Issue
- 6
- Pages
- 670
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6024813
- OpenAlex
- W2804553883
- Cited by
- 25
- References
- 30
- Citations by year
- 2025: 3 · 2024: 7 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 6
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- post-bariatric hypoglycemia, Roux-en-Y gastric bypass, uncooked cornstarch, low glycemic index diet, high-fiber diet, dietary intervention, glycemic variability, continuous glucose monitoring, postprandial hypoglycemia, fasting hypoglycemia, bariatric surgery complications
- MeSH terms
- Adult, Blood Glucose, Dietary Fiber, Female, Humans, Hypoglycemia, Nutritional Status, Starch, Time Factors, Gastric Bypass, Biomarkers, Treatment Outcome, Glycemic Index
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