Post-bariatric Hypoglycemia Management: A Gulf Cooperation Council Consensus Statement.

Area of Science:

• Metabolic and Bariatric Surgery
• Endocrinology
• Gastroenterology

Background:

• Post-bariatric hypoglycemia (PBH) is a significant late complication following metabolic and bariatric surgery.
• PBH presents with a spectrum of symptoms, from mild to severe neuroglycopenic events.
• Current PBH management is heterogeneous due to complex pathophysiology and lack of standardized protocols.

Purpose of the Study:

• To establish a unified, evidence-based, and patient-centered management protocol for PBH.
• To standardize the diagnosis and treatment of PBH across clinical practice.
• To address the heterogeneity in PBH management approaches.

Main Methods:

• A panel of 16 international experts (GCC and Europe) conducted a literature review.
• Consensus statements were developed using the Delphi method.
• 45 statements were agreed upon, covering diagnosis, dietary management, education, and treatment.

Main Results:

• Consensus was reached on 45 statements for comprehensive PBH management.
• Guidelines cover diagnosis, dietary adjustments, patient education, and pharmacological treatment.
• Special considerations for pregnancy, long-term monitoring, and clinical practice are included.

Conclusions:

• Implementation of these consensus statements will standardize PBH management.
• Significant gaps remain, including the need for PBH-specific therapies and robust clinical trials.
• Future research should focus on addressing these identified gaps in PBH care.