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Related Experiment Videos

Hyperinsulinemic hypoglycemia developing late after gastric bypass.

John P Bantle1, Sayeed Ikramuddin, Todd A Kellogg

  • 1Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA. bantl001@umn.edu

Obesity Surgery
|July 31, 2007
PubMed
Summary
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Low carbohydrate diets may effectively treat post-gastric bypass hyperinsulinemic hypoglycemia, a complication causing confusion and loss of consciousness after surgery. This approach avoids invasive treatments like pancreatectomy.

Area of Science:

  • Endocrinology
  • Bariatric Surgery Outcomes
  • Gastroenterology

Background:

  • Post-gastric bypass hyperinsulinemic hypoglycemia is a significant late complication of Roux-en-Y gastric bypass (RYGBP).
  • This condition can manifest as confusion and loss of consciousness.
  • This study reports on three additional patients diagnosed with this disorder.

Observation:

  • Patients aged 50-65 underwent RYGBP for morbid obesity.
  • Symptoms of postprandial confusion and loss of consciousness appeared 15-37 months post-surgery.
  • Test meals revealed exaggerated glucose and insulin responses to high-carbohydrate meals.

Findings:

  • High-carbohydrate meals led to peak plasma glucose >200 mg/dl and serum insulin >300 microU/l.
  • Rapid insulin decline resulted in hypoglycemia (plasma glucose <42 mg/dl) in all patients.

Related Experiment Videos

  • Low-carbohydrate meals did not significantly alter glucose or insulin levels, preventing hypoglycemia.

    • Implications:

    • Low-carbohydrate diets show promise for managing post-gastric bypass hyperinsulinemic hypoglycemia.
    • Rapid carbohydrate digestion and absorption are implicated as key factors in this disorder.
    • Dietary modifications may offer an alternative to pancreatectomy for treating this complication.