Postbariatric surgery hypoglycemia: Nutritional, pharmacological and surgical perspectives

Rossini, Giovanni; Risi, Renata; Monte, Lavinia; Sancetta, Biagio; Quadrini, Maria; Ugoccioni, Massimiliano; Masi, Davide; Rossetti, Rebecca; D’Alessio, Rossella; Mazzilli, Rossella; Defeudis, Giuseppe; Lubrano, Carla; Gnessi, Lucio; Watanabe, Mikiko; Manfrini, Silvia; Tuccinardi, Dario

doi:10.1002/dmrr.3750

Cited by 7 publications

(2 citation statements)

References 179 publications

(347 reference statements)

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“…11 Finally, we have decided to include additional articles that do not necessarily relate to the topic of chrononutrition, but that we believe would still provide extremely important information in their related fields of dietetics, nutrition, and cardiometabolic diseases. These articles include discussions on the role of prebiotics, probiotics, and synbiotics, in patients with type 1 diabetes mellitus 12 the role of transitioning from a metabolically healthy obesity phenotype to a metabolically unhealthy obesity phenotypes on atherosclerotic risk and its related editorial written by experts in the field, 13,14 the role of pharmacologic and nutritional interventions in patients with post-bariatric surgery-related hypoglycaemia 15 and the effects of microbiome and nutraceutical in patients with type 2 diabetes. 16 In conclusion, this Special Issue will provide novel insights and clarifications on chrononutrition, but also on additional controversial topics.…”

Section: Special Issue: Chrononutrition and Other Nutrition Controver...mentioning

confidence: 99%

Chrononutrition in cardiometabolic diseases: Current evidence and future perspectives

Carbone,

Pozzilli

2024

Diabetes Metabolism Res

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Chrononutrition is the field of nutritional science that investigates the relationship between food intake, timing of food intake, and their effects and influence on circadian rhythms and overall health. By aligning eating patterns with body's internal clock, optimisation of metabolic processes, improvements of various aspects of health can be achieved. Cardiovascular (CV) and metabolic diseases remain the leading cause of morbidity and mortality worldwide. Notably, in the US alone, approximately half of all cardiometabolic deaths are attributed to modifiable dietary factors, suggesting that dietary changes could result in dramatic increases in lifespan and its related quality of life. Social media have also a great impact on chrononutrition and their role cannot be neglected. The impact of social media on chrononutrition can be multifaceted: information dissemination, influence on eating habits, digital detox challenges, cultural influence and social jet lag. This special issue will provide novel insights and clarifications on chrononutrition, but also on additional controversial topics. The articles we selected should promote future preclinical and clinical studies to ultimately identify the most appropriate approaches to reduce the unacceptable high burden of CV and metabolic diseases.

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Section: Special Issue: Chrononutrition and Other Nutrition Controver...mentioning

confidence: 99%

Chrononutrition in cardiometabolic diseases: Current evidence and future perspectives

Carbone,

Pozzilli

2024

Diabetes Metabolism Res

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“…It will cover post-bariatric surgery hypoglycaemia, considering nutritional, pharmacological, and surgical aspects. 19…”

Section: Objectivementioning

confidence: 99%

The long‐term effect of bariatric/metabolic surgery versus pharmacologic therapy in type 2 diabetes mellitus patients: A systematic review and meta‐analysis

Yang,

Miao,

Wang

et al. 2024

Diabetes Metabolism Res

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Metabolic/bariatric surgery as a treatment for obesity and related diseases, such as type 2 diabetes mellitus (T2DM), has been increasingly recognised in recent years. However, compared with conventional pharmacologic therapy, the long‐term effect (≥ 5 years) of metabolic surgery in T2DM patients is still unclear. This study aimed to evaluate the diabetes remission rate, incidence of diabetic microvascular complications, incidence of macrovascular complications, and mortality in T2DM patients who received metabolic surgery versus pharmacologic therapy more than 5 years after the surgery. Searching the database, including PubMed, Embase, Web of Science, and Cochrane Library from the inception to recent (2024), for randomised clinical trials (RCTs) or cohort studies comparing T2DM patients treated with metabolic surgery versus pharmacologic therapy reporting on the outcomes of the diabetes remission rate, diabetic microvascular complications, macrovascular complications, or mortality over 5 years or more. A total of 15 articles with a total of 85,473 patients with T2DM were eligible for review and meta‐analysis in this study. There is a significant long‐term increase in diabetes remission for metabolic surgery compared with conventional medical therapy in the overall pooled estimation and RCT studies or cohort studies separately (overall: OR = 4.58, 95% CI: 1.89–11.07, P < 0.001). Significant long‐term decreases were found in the pooled results of microvascular complications incidence (HR = 0.57, 95% CI: 0.41–0.78, P < 0.001), macrovascular complications incidence (HR = 0.59, 95% CI: 0.50–0.70, P < 0.001) and mortality (HR = 0.53, 95% CI: 0.53–0.79, P = 0.0018). Metabolic surgery showed more significant long‐term effects than pharmacologic therapy on diabetes remission, macrovascular complications, microvascular complications incidence, and all‐cause mortality in patients with T2DM using currently available evidence. More high‐quality evidence is needed to validate the long‐term effects of metabolic surgery versus conventional treatment in diabetes management.

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Dumping syndrome: Update on pathophysiology, diagnosis, and management

Tack,

Raymenants,

Van de Bruaene

et al. 2024

Neurogastroenterology Motil

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BackgroundDumping syndrome is a complex of gastrointestinal symptoms originally studied in peptic ulcer surgery patients. At present, it is most prevalent in patients who underwent bariatric, upper gastrointestinal cancer or anti‐reflux surgery. The symptom pattern comprises early and late dumping symptoms. Several management options have been reported including nutritional, pharmacological and surgical approaches.Aims and MethodsIn this study, we aimed to review the current evidence on dumping syndrome definition, diagnosis and treatment, including preliminary data from newer pharmacological studies.ResultsCurrent pathophysiological concepts and analyses of provocative tests has led to a clear definition of dumping syndrome, including both early and late dumping symptoms. The term postbariatric hypoglycemia represents a limited focus on late dumping only. The diagnosis relies on recognition of symptoms and signs in a patient with appropriate surgical history; and can be confirmed by provocative testing or registration of spontaneous hypoglycemia. The initial treatment focuses on dietary intervention, to which meal viscosity enhancers and/or the glycosidase inhibitor acarbose can be added. The most effective therapy is the use of short‐ or long‐acting somatostatin analogues, which is however expensive and entails side effect issues. In case of refractory hypoglycemia, diazoxide or SGLT2 inhibitors can be considered, based on limited evidence. In refractory patients, continuous enteral feeding or (rarely) surgical reinterventions have been advocated, although not supported by solid evidence. Therapies under current evaluation include the broad‐spectrum somatostatin analogue pasireotide, GLP‐1 receptor antagonists, GLP‐1 receptor agonists and administration of stable forms of glucagon are currently under study.ConclusionsDumping syndrome is a well‐defined but probably under‐diagnosed complication of upper gastrointestinal, especially bariatric, and surgeries. Diagnosis is confirmed by a provocative test and incremental therapies starting with diet, adding meal viscosity enhancers or glycosidase inhibitors and adding somatostatin analogues in refractory cases. A number of emerging therapies targeting intestinal propulsion, peptide hormone effects and hypoglycemic events are under evaluation.

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Postbariatric surgery hypoglycemia: Nutritional, pharmacological and surgical perspectives

Cited by 7 publications

References 179 publications

Chrononutrition in cardiometabolic diseases: Current evidence and future perspectives

Chrononutrition in cardiometabolic diseases: Current evidence and future perspectives

The long‐term effect of bariatric/metabolic surgery versus pharmacologic therapy in type 2 diabetes mellitus patients: A systematic review and meta‐analysis

Dumping syndrome: Update on pathophysiology, diagnosis, and management

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