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Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Insulin: Dosing Regimen and Adverse Effects01:16

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Oral Hypoglycemic Agents: Glinides01:06

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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

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Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
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Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

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α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
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Sleeve Gastrectomy in Mice using Surgical Clips
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Hyperinsulinemic Hypoglycemia after Bariatric Surgery.

Songhao Hu1, Hanlin Tang1, Huaxi Wang1

  • 1Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Journal of Metabolic and Bariatric Surgery
|January 23, 2023
PubMed
Summary
This summary is machine-generated.

Postprandial hyperinsulinemic hypoglycemia (PHH) is a serious complication after bariatric surgery. This review covers its symptoms, diagnosis, and treatment options for PHH.

Keywords:
Bariatric surgeryPostprandial hyperinsulinemic hypoglycemia (PHH)Roux-en-Y gastric bypass (RYGB)Sleeve gastrectomy (SG)

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Area of Science:

  • Endocrinology
  • Bariatric Surgery Outcomes
  • Gastroenterology

Background:

  • Postprandial hyperinsulinemic hypoglycemia (PHH) is a severe complication following bariatric surgery.
  • PHH can manifest with dangerous neuroglycopenic symptoms like seizures and loss of consciousness.

Purpose of the Study:

  • To review the presentation, prevalence, pathology, and treatment of PHH after bariatric surgery.
  • To enhance understanding and management of this complication.

Main Methods:

  • Literature review of studies on postprandial hyperinsulinemic hypoglycemia.
  • Synthesis of information regarding diagnosis and therapeutic interventions.

Main Results:

  • PHH presents with a range of neuroglycopenic symptoms.
  • Early diagnosis and appropriate management are crucial for patient outcomes.

Conclusions:

  • PHH is a significant concern after bariatric procedures.
  • Comprehensive review highlights the need for awareness and effective treatment strategies for PHH.