Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry

Obesity Facts
Nuria VilarrasaAlbert Lecube

Abstract

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. Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. 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. There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not res...Continue Reading

Citations

Apr 11, 2017·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Emmy SuhlMary-Elizabeth Patti
Oct 18, 2016·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·A P van BeekJ Tack
Aug 1, 2019·Journal of Clinical Medicine·Stephan R Vavricka, Thomas Greuter
Jul 8, 2020·Scientific Reports·Carolina B LobatoMariana P Monteiro
May 28, 2020·Nature Reviews. Endocrinology·Emidio ScarpelliniJan Tack
Oct 9, 2016·Obesity Surgery·Antonio Luiz de Vasconcellos MacedoFernando Concilio Mauro
Jun 13, 2017·The Journal of Clinical Endocrinology and Metabolism·Kirk W JohnsonPaul Rubin
Dec 18, 2020·Therapeutic Advances in Endocrinology and Metabolism·Basma HarisKhalid Hussain

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Methods Mentioned

BETA
gastric bypass
pancreatectomy

Software Mentioned

Statistical Package for Social Sciences ( SPSS
SPSS

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