Hypoglycemia Worsened by Glucose Administration: A Case of Hypoglycemia Years After Gastric Surgery

McManus, Nicholas M.; Margart, Kendel M.; Offman, Ryan

doi:10.1016/j.jemermed.2020.11.041

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…A life-threatening complication of hyperinsulinemic hypoglycemia has been reported in a minority of patients that underwent Roux-en-Y gastric bypass surgery (RYGB) [4][5][6][7][8]. The underlying physiopathology remains not fully understood, but RYGB leads to earlier and higher glucose peaks, which are responsible for large insulin and glucagon-like peptide 1 (GLP-1) secretion that causes a lower glucose nadir [4][5][6][7][8]. This complication usually presents with neuroglycopenic symptoms several years after surgery [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…The underlying physiopathology remains not fully understood, but RYGB leads to earlier and higher glucose peaks, which are responsible for large insulin and glucagon-like peptide 1 (GLP-1) secretion that causes a lower glucose nadir [4][5][6][7][8]. This complication usually presents with neuroglycopenic symptoms several years after surgery [4][5][6][7][8]. Available therapeutic options are extremely limited; therefore, dietary modifications, such as avoiding simple carbohydrates, and adding protein and fat to every meal to reduce the glucose excursion and hypoglycemia, remain the cornerstone of treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Roux-en-Y Gastric Bypass Surgery Leading to Postprandial Hypoglycemia: A Case Report

Coelho¹,

Freitas²,

Alexandrino³

et al. 2022

Cureus

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Postprandial hypoglycemia is a rare complication after Roux-en-Y gastric bypass (RYGB). The underlying pathophysiology remains to be fully understood.We present a case of a 49-year-old woman with a past medical history of mesenteric thrombosis due to prothrombin-related thrombophilia, which culminated in RYGB 10 years prior to presentation. The patient had been given anticoagulation treatment for several years, which she abandoned one year prior to presentation. She presented to our consultation with episodes of postprandial hypoglycemia and severe anemia due to iron and vitamin B12 deficiencies.Dietary adjustments were set in place to prevent hypoglycemia and neuroglycopenic symptoms. Intravenous iron and intramuscular vitamin B12 supplementation led to full recovery of hemoglobin levels, allowing restart of oral anticoagulation to prevent recurrence of thrombotic events.

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