Hypoglycemia Following Bariatric Surgery: Our 31-Year Experience

Hypoglycemia Following Bariatric Surgery: Our 31-Year Experience Purpose The purposes of this study are to identify the cumu- PBSH with preoperative median age of 43 years, mean BMI lative incidence of post-bariatric surgery hypoglycemia of 50.0 kg/m , and median glycated hemoglobin of 6.0%. (PBSH), describe its symptomatology, and characterize treat- Median time-to-first hypoglycemic event was 40.6 months. ment patterns at a large academic institution. No factors were identified which predict symptom severity Materials and Methods All patients who underwent bariatric or resolution. The 24 (27%) patients who received pharmaco- surgery at a single institution from 1985 to 2015 were identi- therapy to treat hypoglycemia were younger, had lower nadir fied using a clinical database, administrative billing data iden- blood glucose levels, and more frequent symptoms. Sixty- tified patients who were treated for hypoglycemia, and chart nine (79%) cases eventually resolved. reviews were performed to make a diagnosis of PBSH based Conclusions PBSH onset and severity are highly variable. on Whipple’s triad. PBSH cases were reviewed including pa- Successful management of these patients can prove difficult tient diabetes history, symptomatology, and treatment mea- and should include dietary therapy, the selective use of phar- sures. Univariate analyses were performed to identify correla- macotherapy and surgery, and the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Obesity Surgery Springer Journals

Hypoglycemia Following Bariatric Surgery: Our 31-Year Experience

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Publisher
Springer Journals
Copyright
Copyright © 2017 by Springer Science+Business Media New York
Subject
Medicine & Public Health; Surgery
ISSN
0960-8923
eISSN
1708-0428
D.O.I.
10.1007/s11695-017-2734-2
Publisher site
See Article on Publisher Site

Abstract

Purpose The purposes of this study are to identify the cumu- PBSH with preoperative median age of 43 years, mean BMI lative incidence of post-bariatric surgery hypoglycemia of 50.0 kg/m , and median glycated hemoglobin of 6.0%. (PBSH), describe its symptomatology, and characterize treat- Median time-to-first hypoglycemic event was 40.6 months. ment patterns at a large academic institution. No factors were identified which predict symptom severity Materials and Methods All patients who underwent bariatric or resolution. The 24 (27%) patients who received pharmaco- surgery at a single institution from 1985 to 2015 were identi- therapy to treat hypoglycemia were younger, had lower nadir fied using a clinical database, administrative billing data iden- blood glucose levels, and more frequent symptoms. Sixty- tified patients who were treated for hypoglycemia, and chart nine (79%) cases eventually resolved. reviews were performed to make a diagnosis of PBSH based Conclusions PBSH onset and severity are highly variable. on Whipple’s triad. PBSH cases were reviewed including pa- Successful management of these patients can prove difficult tient diabetes history, symptomatology, and treatment mea- and should include dietary therapy, the selective use of phar- sures. Univariate analyses were performed to identify correla- macotherapy and surgery, and the

Journal

Obesity SurgerySpringer Journals

Published: May 13, 2017

References

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