Relationship between biochemical and symptomatic hypoglycemia after RYGB. Responses to a mixed meal test: a case-control study
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Background: Postprandial hypoglycemia is a relatively common complication after Roux-en-Y gastric bypass (RYGB). The cause remains incompletely understood, and the association between biochemical hypoglycemia and hypoglycemic symptoms is unclear.
Objectives: To evaluate the association between postprandial hormonal responses and biochemical and symptomatic hypoglycemia after RYGB.
Setting: University Hospital, Denmark.
Methods: A case-control study with 3 groups: (1) RYGB group with postprandial hypoglycemic symptoms (HS), n = 13; (2) RYGB-group with no symptoms of hypoglycemia (NHS), n = 13; and (3) nonoperated body mass index-matched controls (CON), n = 7. Plasma glucose (PG) and hormonal responses (insulin, glucagon-like peptide-1, gastric inhibitory polypeptide, glucagon) were measured after a mixed meal test (MMT), and hypoglycemic symptoms were determined by a questionnaire. The primary outcomes were differences in subjective and biochemical responses related to hypoglycemia among the 3 groups.
Results: Nadir PG was lower (3.1 versus 4.0 mmol/L (56 versus 72 mg/dL); P = .0002) and peak insulin higher in HS than NHS patients (1073 versus 734 pmol/L; P = .0499). Of the 13 patients with a peak insulin >850 pmol/L, 8 patients developed symptoms whereas only 2 out of the 13 patients with peak insulin 3 mmol/L (54 mg/dL) revealed a difference in both peak insulin (1138 versus 760 pmol/L; P = .042) and peak glucagon-like peptide-1 (182 versus 86 pmol/L; P = .016) concentrations.
Conclusions: Patients with HS had lower nadir PG and higher insulin responses than NHS patients after MMT. Regarding PG, PG
Original language | English |
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Journal | Surgery for Obesity and Related Diseases |
Volume | 16 |
Issue number | 9 |
Pages (from-to) | 1179-1185 |
Number of pages | 7 |
ISSN | 1550-7289 |
DOIs | |
Publication status | Published - 2020 |
- Roux-en-Y gastric bypass, Hypoglycemia, Insulin, Glucagon-like peptide-1, Mixed meal test, GASTRIC-BYPASS-SURGERY, BARIATRIC SURGERY, ORAL GLUCOSE, NEUROGLYCOPENIA, PREVALENCE, SECRETION, INCRETIN, GLP-1
Research areas
ID: 250118045