Top

Published in:

01-07-2014 | Brief Communication

Hypoglycemia after Roux-en-Y Gastric Bypass: The BOLD Experience

Authors: Hafiz Sarwar, William H. Chapman III, John R. Pender, Andrada Ivanescu, Almond J. Drake III, Walter J. Pories, Moahad S. Dar

Published in: Obesity Surgery | Issue 7/2014

Excerpt

Obesity is a global epidemic associated with higher mortality and increased incidence of type 2 diabetes, hypertension, and obstructive sleep apnea [1]. Although dietary and lifestyle interventions can achieve modest weight loss, they are difficult to sustain over the long-term [2]. Patients are increasingly turning to bariatric surgery to achieve greater weight loss and increase remission of type 2 diabetes, hypertension, and obstructive sleep apnea. Roux-en-y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures due to its safety (mortality ~0.5 %), efficacy in weight loss (~60 % excess weight lost), and disease remission (77 % for type 2 diabetes, 62 % for hypertension, 86 % for obstructive sleep apnea) [3]. …

Sjöström L, Lindroos AK, Peltonen M, et al. Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. Surgery. 2004;351(26):2683–93.

Henry RR, Chilton R, Garvey WT. New options for the treatment of obesity and type 2 diabetes mellitus. J Diabetes Complicat. 2013;S1056–8727(13):00106–2.

Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef

Nguyen et al. Trends in use of bariatric surgery, 2003-2008. J Am Coll Surg. 2011; 213(2):261

Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide. 2008. Obes Surg. 2009;198:1605–11.CrossRef

Marsk R, Jonas E, Rasmussen F, et al. Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986–2006 in Sweden. Diabetologia. 2010;53(11):2307–11.PubMedCrossRef

Kellogg TA, Bantle JP, Leslie DB, et al. Postgastric bypass hyperinsulinemic hypoglycemia syndrome: characterization and response to a modified diet. Surg Obes Relat Dis. 2008;4(4):492–9.PubMedCrossRef

Service GJ, Thompson GB, Service FJ, et al. Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med. 2005;353(3):249–54.PubMedCrossRef

Patti ME, McMahon G, Mun EC, et al. Severe hypoglycemia post-gastric bypass requiring partial pancreatectomy: evidence for inappropriate insulin secretion and pancreatic islet hyperplasia. Diabetologia. 2005;48(11):2236–40.PubMedCrossRef

10.

Claney TE, Moore Jr FD, Zinner MJ. Post-gastric bypass hyperinsulinism with nesidioblastosis: subtotal or total pancreatectomy may be needed to prevent recurrent hypoglycemia. J Gastrointest Surg. 2006;10(8):1116–9.CrossRef

11.

Alvarez GC, Faria EN, Beck M, et al. Laparoscopic spleen-preserving distal pancreatectomy as treat for nesidiobalstosis after gastric bypass surgery. Obes Surg. 2007;17(4):550–2.PubMedCrossRef

12.

Meier JJ, Butler AE, Galasso R, et al. Hyperinsulinemic hypoglycemia after gastric bypass surgery is not accompanied by islet hyperplasia or increased beta-cell turnover. Diabetes Care. 2006;29(7):1554–9.PubMedCrossRef

13.

Goldfine AB, Mun EC, Devine E, et al. Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab. 2007;92(12):4678–85.PubMedCrossRef

14.

Salehi M, Prigeon RL, D'Alessio DA. Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. Diabetes. 2011;60(9):2308–14.PubMedCentralPubMedCrossRef

15.

Bantle JP, Ikramuddin S, Kellog TA, et al. Hyperinsulinemic hypoglycemia developing late after gastric bypass. Obes Surg. 2007;17:592–4.PubMedCrossRef

16.

Z’graggen K, Guweidhi A, Steffen R, et al. Severe recurrent hypoglycemia after gastric bypass surgery. Obes Surg. 2008;18:981–8.PubMedCrossRef

17.

Gonzalez-Gonzalez A, Delgado M, Fraga-Fuentes MD. Use of diazoxide in management of severe postprandial hypoglycemia in patient after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9(1):e18–9.PubMedCrossRef

18.

Moreira RO, Moreira RB, Machado NA, et al. Post-prandial hypoglycemia after bariatric surgery: pharmacological treatment with verapamil and acarbose. Obes Surg. 2008;18(12):1618–21.PubMedCrossRef

19.

Myint KS, Greenfield JR, Farooqi IS, et al. Prolonged successful therapy for hyperinsulinaemic hypoglycaemia after gastric bypass: the pathophysiological role of GLP1 and its response to a somatostatin analogue. Eur J Endocrinol. 2012;166(5):951–5.PubMedCrossRef

Title: Hypoglycemia after Roux-en-Y Gastric Bypass: The BOLD Experience
Authors: Hafiz Sarwar
William H. Chapman III
John R. Pender
Andrada Ivanescu
Almond J. Drake III
Walter J. Pories
Moahad S. Dar
Publication date: 01-07-2014
Publisher: Springer US
Published in: Obesity Surgery / Issue 7/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-014-1260-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Hypoglycemia after Roux-en-Y Gastric Bypass: The BOLD Experience

Excerpt

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 7/2014

Laparoscopic Sleeve Gastrectomy Using 42-French Versus 32-French Bougie: The First-Year Outcome

Short-Term Outcomes of Sleeve Gastrectomy for Morbid Obesity: Does Staple Line Reinforcement Matter?

Improving Outcome of Bariatric Surgery: Best Practices in an Accredited Surgical Center

Two Hundred Seventy-Five Single-Incision Laparoscopic Gastric Band Insertions: What Have We Learnt?

Validating the Alterable Weight Loss (AWL) Metric with 2-Year Weight Loss Outcome of 500 Patients After Gastric Bypass

Laparoscopic Sleeve Gastrectomy Using 42-French Versus 32-French Bougie