PMID- 31412234
OWN - NLM
STAT- Publisher
LR  - 20240227
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
DP  - 2019 Aug 14
TI  - SYMPTOMATIC AND ASYMPTOMATIC HYPOGLYCEMIA POST THREE DIFFERENT BARIATRIC 
      PROCEDURES: A COMMON AND SEVERE COMPLICATION.
LID - 10.4158/EP-2019-0185 [doi]
AB  - Background: The prevalence of post-bariatric surgery hypoglycemia (PBH) remains 
      unclear due to diagnostic criteria variability, types of bariatric procedures and 
      possible unawareness. Objective: To determine the frequency, pattern and severity 
      of symptomatic and asymptomatic hypoglycemia in subjects post three different 
      bariatric procedures performed >1 year before evaluation and a group of obese 
      subjects before surgery. Design and Setting: Observational cohort study. 
      Fifty-one consecutive patients participated: post Roux-en-Y gastric-bypass (RYGB) 
      (n=16), post omega-loop gastric-bypass (OLGB) (n=12), post sleeve-gastrectomy 
      (SG) (n=15), obese subjects before surgery (controls) (n=8). Hypoglycemic events 
      (glucose </=54 mg/dL) and severe hypoglycemia (glucose </=40 mg/dL) were evaluated by 
      symptoms' questionnaire, mixed-meal tolerance test (MMTT) and continuous glucose 
      monitoring (CGM). Results: According to questionnaires, meal-related complaints 
      were reported in 11 (26%) of the surgical group and in one control subject. 
      During MMTT, 88%, 82% and 67% experienced hypoglycemia in RYGB, OMGB and SG 
      groups, respectively, vs. none of the controls (P<0.001). Severe hypoglycemia 
      occurred in 38%, 45% and 7% in RYGB, OMGB and SG groups, respectively (P=0.025), 
      but only 10 of the total operated patients (24%) reported any symptoms. During 
      CGM, fasting hypoglycemic events occurred more in RYGB and OLGB vs. SG group: 
      55%, 63% and 17% respectively (P=0.036). Conclusions: PBH is very common after 
      RYGB, OMGB and SG and can be severe especially following bypass procedures. Our 
      results show that hypoglycemia occurs not only postprandially but also in the 
      fasting state, especially following bypass procedures. In most cases, there were 
      no specific complaints, possibly leading to its underestimation.
FAU - Lazar, Li Or
AU  - Lazar LO
AD  - From: 1Surgery Department, Kaplan Medical Center, Hebrew University Medical 
      School, Rehovot, Israel.
FAU - Sapojnikov, Shimon
AU  - Sapojnikov S
AD  - From: 1Surgery Department, Kaplan Medical Center, Hebrew University Medical 
      School, Rehovot, Israel.
FAU - Pines, Guy
AU  - Pines G
AD  - From: 1Surgery Department, Kaplan Medical Center, Hebrew University Medical 
      School, Rehovot, Israel.
FAU - Mavor, Eli
AU  - Mavor E
AD  - From: 1Surgery Department, Kaplan Medical Center, Hebrew University Medical 
      School, Rehovot, Israel.
FAU - Ostrovsky, Viviana
AU  - Ostrovsky V
AD  - Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, 
      Hebrew University Medical School, Rehovot, Israel.
FAU - Schiller, Tal
AU  - Schiller T
AD  - Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, 
      Hebrew University Medical School, Rehovot, Israel.
FAU - Knobler, Hilla
AU  - Knobler H
AD  - Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, 
      Hebrew University Medical School, Rehovot, Israel.
FAU - Zornitzki, Taiba
AU  - Zornitzki T
AD  - Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, 
      Hebrew University Medical School, Rehovot, Israel.
LA  - eng
PT  - Journal Article
DEP - 20190814
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
SB  - IM
OTO - NOTNLM
OT  - Bariatric surgery
OT  - OLGB
OT  - RYGB
OT  - SG
OT  - post-bariatric hypoglycemia
EDAT- 2019/08/15 06:00
MHDA- 2019/08/15 06:00
CRDT- 2019/08/15 06:00
PHST- 2019/08/15 06:00 [entrez]
PHST- 2019/08/15 06:00 [pubmed]
PHST- 2019/08/15 06:00 [medline]
AID - 10.4158/EP-2019-0185 [doi]
PST - aheadofprint
SO  - Endocr Pract. 2019 Aug 14. doi: 10.4158/EP-2019-0185.