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The following is a summary of “Defining Clinical Characteristics of Individuals With and Without Post-Bariatric Hypoglycemia After Gastric Bypass,” published in the November 2024 issue of Endocrinology by Grover et al.     

Post-bariatric hypoglycemia (PBH) is a complication following Roux-en-Y gastric bypass (RYGB) surgery, but the reasons for its occurrence in some individuals remain unclear.  

Researchers conducted a cross-sectional study to identify clinical differences between individuals with and without symptomatic hypoglycemia after RYGB.  

They recruited adults (18-70 years) without current diabetes from an academic referral center into 3 groups, PBH (n=39), RYGB non-hypoglycemia (n=25), and controls (n=17). Medical history, medication use, and survey scores were compared for hypoglycemia, dumping syndrome, and autonomic symptoms.  

The results showed that individuals with PBH were 92% female (average age 53.4 ± 11.9 years, body mass index [BMI] 31.2 ± 5.6 kg/m²), compared to 100% female individuals with RYGB non-hypoglycemia (average age 53.2 ± 10.5 years, BMI 32.2 ± 8.0 kg/m²) and 65% female controls (average age 44.5 ± 14.6 years, BMI 30.8 ± 6.3 kg/m²). Among individuals with PBH, 87% reported experiencing level 3 hypoglycemia, 28% had emergency visits, and 8% were involved in vehicle accidents. Individuals with PBH also reported more autonomic symptoms (P<0.05) and more frequent use of gabapentin and proton pump inhibitors (PPIs). Additionally, 82% of individuals with PBH reported reduced awareness of hypoglycemia and 26% experienced preoperative hypoglycemia symptoms.  

They concluded that autonomic dysregulation and preoperative hypoglycemia symptoms may contribute to PBH.  

Source: onlinelibrary.wiley.com/doi/abs/10.1111/cen.15169