Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass

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Standard

Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass. / Øhrstrøm, Caroline C.; Worm, Dorte; Kielgast, Urd Lynge; Holst, Jens Juul; Hansen, Dorte L.

In: Obesity Surgery, Vol. 30, No. 3, 2020, p. 1038-1045.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Øhrstrøm, CC, Worm, D, Kielgast, UL, Holst, JJ & Hansen, DL 2020, 'Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass', Obesity Surgery, vol. 30, no. 3, pp. 1038-1045. https://doi.org/10.1007/s11695-020-04387-6

APA

Øhrstrøm, C. C., Worm, D., Kielgast, U. L., Holst, J. J., & Hansen, D. L. (2020). Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass. Obesity Surgery, 30(3), 1038-1045. https://doi.org/10.1007/s11695-020-04387-6

Vancouver

Øhrstrøm CC, Worm D, Kielgast UL, Holst JJ, Hansen DL. Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass. Obesity Surgery. 2020;30(3):1038-1045. https://doi.org/10.1007/s11695-020-04387-6

Author

Øhrstrøm, Caroline C. ; Worm, Dorte ; Kielgast, Urd Lynge ; Holst, Jens Juul ; Hansen, Dorte L. / Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass. In: Obesity Surgery. 2020 ; Vol. 30, No. 3. pp. 1038-1045.

Bibtex

@article{8299d835a0a949b7be69cab213a225bf,
title = "Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass",
abstract = "Background Early dumping and post-bariatric hypoglycemia (PBH) are often addressed as two separate postprandial complications after Roux-en-Y gastric bypass (RYGB). The aim of the study was to evaluate the occurrence of early dumping in RYGB-operated individuals with PBH with and without treatment intervention. Methods Eleven RYGB-operated women with documented PBH each underwent a baseline liquid mixed meal test (MMT) followed by five MMTs preceded by treatment with: acarbose 50 mg for 1 week, sitagliptin 100 mg for 1 week, verapamil 120 mg for 1 week, liraglutide 1.2 mg for 3 weeks, and pasireotide 300 mu g as a single dose. Repetitive venous blood sampling and continuous electrocardiogram recordings were performed at fasting and during a 3-h postprandial period. Results During the baseline MMT, there was a significant increase in HR (from 65 +/- 2 to 90 +/- 4 bpm, p <0.0001) within 30 min after meal intake, while hypoglycemia occurred in the later postprandial period. The HR increase was accompanied by significant increases in serum albumin, plasma norepinephrine, blood glucose, serum insulin, and plasma GLP-1 concentrations. The postprandial HR changes were positively correlated with the changes in insulin and GLP-1 concentrations. Treatment with acarbose and pasireotide both reduced HR, plasma norepinephrine, and serum insulin, and pasireotide also decreased plasma GLP-1. Conclusions RYGB-operated individuals with PBH also have large early postprandial HR increases, hemoconcentration, and sympathetic activation, consistent with early dumping. Moreover, hormone excursions associated with PBH appear to be related to measures of early dumping, suggesting a causal relationship between early dumping and PBH.",
keywords = "Gastric bypass, Postprandial hypoglycemia, Early dumping, Heart rate, Mixed meal test, GLUCOSE-METABOLISM, PEPTIDE-1 GLP-1, BLOOD-PRESSURE, HEART-RATE, GLUCAGON, SURGERY, SYMPTOMS, PATHOPHYSIOLOGY, PROVOCATION, PREVALENCE",
author = "{\O}hrstr{\o}m, {Caroline C.} and Dorte Worm and Kielgast, {Urd Lynge} and Holst, {Jens Juul} and Hansen, {Dorte L.}",
year = "2020",
doi = "10.1007/s11695-020-04387-6",
language = "English",
volume = "30",
pages = "1038--1045",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer",
number = "3",

}

RIS

TY - JOUR

T1 - Evidence for Relationship Between Early Dumping and Postprandial Hypoglycemia After Roux-en-Y Gastric Bypass

AU - Øhrstrøm, Caroline C.

AU - Worm, Dorte

AU - Kielgast, Urd Lynge

AU - Holst, Jens Juul

AU - Hansen, Dorte L.

PY - 2020

Y1 - 2020

N2 - Background Early dumping and post-bariatric hypoglycemia (PBH) are often addressed as two separate postprandial complications after Roux-en-Y gastric bypass (RYGB). The aim of the study was to evaluate the occurrence of early dumping in RYGB-operated individuals with PBH with and without treatment intervention. Methods Eleven RYGB-operated women with documented PBH each underwent a baseline liquid mixed meal test (MMT) followed by five MMTs preceded by treatment with: acarbose 50 mg for 1 week, sitagliptin 100 mg for 1 week, verapamil 120 mg for 1 week, liraglutide 1.2 mg for 3 weeks, and pasireotide 300 mu g as a single dose. Repetitive venous blood sampling and continuous electrocardiogram recordings were performed at fasting and during a 3-h postprandial period. Results During the baseline MMT, there was a significant increase in HR (from 65 +/- 2 to 90 +/- 4 bpm, p <0.0001) within 30 min after meal intake, while hypoglycemia occurred in the later postprandial period. The HR increase was accompanied by significant increases in serum albumin, plasma norepinephrine, blood glucose, serum insulin, and plasma GLP-1 concentrations. The postprandial HR changes were positively correlated with the changes in insulin and GLP-1 concentrations. Treatment with acarbose and pasireotide both reduced HR, plasma norepinephrine, and serum insulin, and pasireotide also decreased plasma GLP-1. Conclusions RYGB-operated individuals with PBH also have large early postprandial HR increases, hemoconcentration, and sympathetic activation, consistent with early dumping. Moreover, hormone excursions associated with PBH appear to be related to measures of early dumping, suggesting a causal relationship between early dumping and PBH.

AB - Background Early dumping and post-bariatric hypoglycemia (PBH) are often addressed as two separate postprandial complications after Roux-en-Y gastric bypass (RYGB). The aim of the study was to evaluate the occurrence of early dumping in RYGB-operated individuals with PBH with and without treatment intervention. Methods Eleven RYGB-operated women with documented PBH each underwent a baseline liquid mixed meal test (MMT) followed by five MMTs preceded by treatment with: acarbose 50 mg for 1 week, sitagliptin 100 mg for 1 week, verapamil 120 mg for 1 week, liraglutide 1.2 mg for 3 weeks, and pasireotide 300 mu g as a single dose. Repetitive venous blood sampling and continuous electrocardiogram recordings were performed at fasting and during a 3-h postprandial period. Results During the baseline MMT, there was a significant increase in HR (from 65 +/- 2 to 90 +/- 4 bpm, p <0.0001) within 30 min after meal intake, while hypoglycemia occurred in the later postprandial period. The HR increase was accompanied by significant increases in serum albumin, plasma norepinephrine, blood glucose, serum insulin, and plasma GLP-1 concentrations. The postprandial HR changes were positively correlated with the changes in insulin and GLP-1 concentrations. Treatment with acarbose and pasireotide both reduced HR, plasma norepinephrine, and serum insulin, and pasireotide also decreased plasma GLP-1. Conclusions RYGB-operated individuals with PBH also have large early postprandial HR increases, hemoconcentration, and sympathetic activation, consistent with early dumping. Moreover, hormone excursions associated with PBH appear to be related to measures of early dumping, suggesting a causal relationship between early dumping and PBH.

KW - Gastric bypass

KW - Postprandial hypoglycemia

KW - Early dumping

KW - Heart rate

KW - Mixed meal test

KW - GLUCOSE-METABOLISM

KW - PEPTIDE-1 GLP-1

KW - BLOOD-PRESSURE

KW - HEART-RATE

KW - GLUCAGON

KW - SURGERY

KW - SYMPTOMS

KW - PATHOPHYSIOLOGY

KW - PROVOCATION

KW - PREVALENCE

U2 - 10.1007/s11695-020-04387-6

DO - 10.1007/s11695-020-04387-6

M3 - Journal article

C2 - 31907828

VL - 30

SP - 1038

EP - 1045

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 3

ER -

ID: 250546760