Post-bariatric hypoglycaemia diagnosed during pregnancy.

Area of Science:

• Endocrinology
• Obstetrics
• Bariatric Surgery

Background:

• Post-bariatric hypoglycemia (PBH) is a recognized complication following Roux-en-Y gastric bypass (RYGB) surgery.
• PBH during pregnancy poses risks to both mother and fetus, including hyperglycemia and hypoglycemia with potential adverse outcomes.
• Literature on PBH in pregnancy is scarce, highlighting a need for increased clinical awareness.

Purpose of the Study:

• To describe a case of symptomatic PBH in a pregnant patient.
• To emphasize the importance of early diagnosis and management of PBH during pregnancy.
• To advocate for improved pre-operative patient counseling regarding potential RYGB complications.

Main Methods:

• Case report of a young pregnant woman diagnosed with PBH in the second trimester.
• Utilized continuous glucose monitoring (CGM) for diagnosis.
• Implemented dietary modifications focusing on low glycemic index and complex carbohydrates.

Main Results:

• Symptomatic PBH was diagnosed using CGM three years post-RYGB surgery.
• Dietary intervention significantly improved glycemic excursions.
• The case highlights the underdiagnosis of PBH as a late complication of RYGB.

Conclusions:

• PBH is an underdiagnosed complication of RYGB surgery, particularly in pregnant women.
• Continuous glucose monitoring is a valuable tool for diagnosing PBH in pregnancy.
• Enhanced patient education and early symptom recognition are crucial for managing PBH during pregnancy.