RESUMO
BACKGROUND: Roux-en-Y gastric bypass surgery (RYGB) increases the rate of alcohol absorption so that peak blood alcohol concentration is 2-fold higher after surgery compared with concentrations reached after consuming the same amount presurgery. Because high doses of alcohol can lead to hypoglycemia, patients may be at increased risk of developing hypoglycemia after alcohol ingestion. OBJECTIVES: We conducted 2 studies to test the hypothesis that the consumption of approximately 2 standard drinks of alcohol would decrease glycemia more after RYGB than before surgery. SETTING: Single-center prospective randomized trial. METHODS: We evaluated plasma glucose concentrations and glucose kinetics (assessed by infusing a stable isotopically labelled glucose tracer) after ingestion of a nonalcoholic drink (placebo) or an alcoholic drink in the following groups: (1) 5 women before RYGB (body mass indexâ¯=â¯43 ± 5 kg/m2) and 10 ± 2 months after RYGB (body mass indexâ¯=â¯31 ± 7 kg/m2; study 1), and (2) 8 women who had undergone RYGB surgery 2.2 ± 1.2 years earlier (body mass indexâ¯=â¯30 ± 5 kg/m2; study 2) RESULTS: Compared with the placebo drink, alcohol ingestion decreased plasma glucose both before and after surgery, but the reduction was greater before (glucose nadir placeboâ¯=â¯-.4 ± 1.0 mg/dL versus alcoholâ¯=â¯-9.6 ± 1.5 mg/dL) than after (glucose nadir placeboâ¯=â¯-1.0 ± 1.6 mg/dL versus alcoholâ¯=â¯-5.5 ± 2.6 mg/dL; P < .001) surgery. This difference was primarily due to an alcohol-induced early increase followed by a subsequent decrease in the rate of glucose appearance into systemic circulation. CONCLUSION: RYGB does not increase the risk of hypoglycemia after consumption of a moderate dose of alcohol.