Hyperinsulinemic hypoglycemia developing late after gastric bypass.
Obes Surg
; 17(5): 592-4, 2007 May.
Article
em En
| MEDLINE
| ID: mdl-17658016
ABSTRACT
BACKGROUND:
Post-gastric bypass hyperinsulinemic hypoglycemia causing confusion and loss of consciousness was recently described, and appears to be an important late complication of gastric bypass surgery. We report 3 additional patients with this disorder, and describe their responses to high and low carbohydrate test meals. PATIENTS The patients were 1 woman and 2 men ranging in age from 50 to 65 years who underwent Roux-en-Y gastric bypass (RYGBP) for morbid obesity. 15 to 37 months after surgery, they started to have episodes of postprandial confusion and loss of consciousness.RESULTS:
When given high carbohydrate mixed meals, all 3 demonstrated peak plasma glucose >200 mg/dl (11.1 mmol/l) and peak serum insulin >300 microU/l (1800 pmol/l). Although serum insulin declined rapidly, all 3 developed hypoglycemia with plasma glucose <42 mg/dl (2.3 mmol/l). Following low carbohydrate test meals, there was little change in plasma glucose or serum insulin and no hypoglycemia.CONCLUSIONS:
Our data suggest that low carbohydrate diets may be effective in treating post-gastric bypass hyperinsulinemic hypoglycemia. We hypothesize that rapid digestion and absorption of carbohydrate is an important feature of this disorder and may be treated with measures other than pancreatectomy.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Derivação Gástrica
/
Hiperinsulinismo
/
Hipoglicemia
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article