Persistent post-bariatric-surgery hypoglycemia: A long-term follow-up reassessment.

Area of Science:

• Endocrinology
• Gastroenterology
• Metabolic Surgery

Background:

• Post-bariatric-surgery hypoglycemia (PBH) is a significant complication following bariatric surgery (BS).
• Previous studies indicated a high prevalence of PBH, but long-term data on its resolution is lacking.

Purpose of the Study:

• To re-evaluate patients from a prior study to assess changes in the frequency and severity of hypoglycemic events over time.
• To determine if PBH resolves with extended follow-up after bariatric surgery.

Main Methods:

• A cohort of 24 post-BS patients (Roux-en-Y gastric-bypass, omega-loop gastric-bypass, sleeve gastrectomy) underwent re-evaluation 34.4 months after initial assessment.
• Assessments included dietitian evaluation, questionnaires, meal tolerance tests (MTT), and one-week continuous glucose monitoring (CGM).
• Hypoglycemia defined as glucose ≤54 mg/dl; severe hypoglycemia as glucose ≤40 mg/dl.

Main Results:

• During MTT, 75% of patients experienced hypoglycemia, with a third having severe hypoglycemia, often without specific symptoms.
• CGM revealed hypoglycemia in 66% of patients and severe hypoglycemia in 37%.
• No significant improvement in hypoglycemic events was observed compared to the previous assessment; however, no hospitalizations or deaths occurred.

Conclusions:

• Post-bariatric-surgery hypoglycemia does not resolve within the long-term follow-up period.
• The majority of patients were unaware of their hypoglycemic events, potentially leading to underestimation of the condition's impact.
• Further research is necessary to understand the long-term sequelae of recurrent hypoglycemia after bariatric surgery.