POSTBARIATRIC HYPOGLYCEMIA Flashcards
What is the effect of gastric bypass on carbohydrate metabolism?
Dramatic improvement in carbohydrate metabolism post-surgery. 80% of preoperative diabetic patients no longer need diabetes medication after surgery. Diabetes often resolves within weeks.
What mechanism leads to the improvement in carbohydrate metabolism after gastric bypass?
Exposure of distal bowel to food increases GLP-1 secretion. Enhanced GLP-1 may improve glucose control.
What is postprandial hypoglycemia?
An uncommon late complication that may result from GLP-1 stimulation causing B-cell proliferation (nesidioblastosis) and is associated with excessive insulin secretion.
What are the causes of endogenous hyperinsulinemic hypoglycemia?
Excessive insulin secretion and development of multiple small insulinomas.
What is the preferred initial treatment for postbariatric hypoglycemia?
Low-carbohydrate diet (50% to 70% symptom alleviation) and consumption of low-glycemic index carbohydrates in mixed meals.
What alternative treatments are available for postbariatric hypoglycemia?
Acarbose, octreotide, calcium channel blockers, and diazoxide.
What surgical intervention was initially suggested for postbariatric hypoglycemia?
Partial pancreatectomy.
What are the risks associated with surgical intervention for postbariatric hypoglycemia?
Risk of recurrence and potential for pancreatic diabetes with aggressive surgery.
True or False: Postprandial hypoglycemia is a common complication after gastric bypass surgery.
False.
Fill in the blank: Exposure of distal bowel to food increases _______ secretion.
GLP-1
What percentage of preoperative diabetic patients no longer need diabetes medication after gastric bypass surgery?
80%
