Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry

Background: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. Methods: Multice...

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Authors: Vilarrasa, Nuria, Goday Arnó, Albert, Rubio, Miguel Angel, Caixàs i Pedragós, Assumpta, Pellitero, Silvia, Ciudin, Andreea, Calañas, Alfonso, Botella, José Ignacio, Bretón Lesmes, Irene, Morales, María José, Díaz Fernández, María Jesús, García Luna, Pedro Pablo, Lecube, Albert
Format: article
Status:Published version
Publication Date:2016
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/126907
Online Access:https://hdl.handle.net/2445/126907
Access Level:Open access
Keyword:Hipoglucèmia
Cirurgia de l'obesitat
Hypoglycemia
Obesity surgery
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spelling Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter RegistryVilarrasa, NuriaGoday Arnó, AlbertRubio, Miguel AngelCaixàs i Pedragós, AssumptaPellitero, SilviaCiudin, AndreeaCalañas, AlfonsoBotella, José IgnacioBretón Lesmes, IreneMorales, María JoséDíaz Fernández, María JesúsGarcía Luna, Pedro PabloLecube, AlbertHipoglucèmiaCirurgia de l'obesitatHypoglycemiaObesity surgeryBackground: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. Methods: Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. Results: Over 11 years of follow-up, 22 patients were identified. The test most used to provoke hypoglycemia was the oral glucose load test followed by the mixed meal test which was the least standardized test. With pharmacological treatment, 3 patients were symptom-free (with octreotide) and in 12 patients hypoglycemic episodes were attenuated. Seven patients had persistent hypoglycemic episodes and underwent surgery. Partial pancreatectomy was performed in 3 patients who had positive selective arterial calcium stimulation, and nesidioblastosis was confirmed in 2 patients. Reconversion to normal anatomy was performed in 3 patients, and 1 patient underwent a resection of the 'candy cane' roux limb, with resolution of hypoglycemia in all cases. Conclusions: There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not respond to pharmacological treatment, reconstruction of gastrojejunal continuity may be the safest and most successful procedure.Karger2018201820162018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion11 p.application/pdfhttps://hdl.handle.net/2445/126907Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1159/000442764Obesity Facts, 2016, vol. 9, num. 1, p. 41-51https://doi.org/10.1159/000442764cc by-nc (c) Karger, 2016http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1269072026-05-29T05:05:01Z
dc.title.none.fl_str_mv Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
title Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
spellingShingle Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
Vilarrasa, Nuria
Hipoglucèmia
Cirurgia de l'obesitat
Hypoglycemia
Obesity surgery
title_short Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
title_full Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
title_fullStr Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
title_full_unstemmed Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
title_sort Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry
dc.creator.none.fl_str_mv Vilarrasa, Nuria
Goday Arnó, Albert
Rubio, Miguel Angel
Caixàs i Pedragós, Assumpta
Pellitero, Silvia
Ciudin, Andreea
Calañas, Alfonso
Botella, José Ignacio
Bretón Lesmes, Irene
Morales, María José
Díaz Fernández, María Jesús
García Luna, Pedro Pablo
Lecube, Albert
author Vilarrasa, Nuria
author_facet Vilarrasa, Nuria
Goday Arnó, Albert
Rubio, Miguel Angel
Caixàs i Pedragós, Assumpta
Pellitero, Silvia
Ciudin, Andreea
Calañas, Alfonso
Botella, José Ignacio
Bretón Lesmes, Irene
Morales, María José
Díaz Fernández, María Jesús
García Luna, Pedro Pablo
Lecube, Albert
author_role author
author2 Goday Arnó, Albert
Rubio, Miguel Angel
Caixàs i Pedragós, Assumpta
Pellitero, Silvia
Ciudin, Andreea
Calañas, Alfonso
Botella, José Ignacio
Bretón Lesmes, Irene
Morales, María José
Díaz Fernández, María Jesús
García Luna, Pedro Pablo
Lecube, Albert
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Hipoglucèmia
Cirurgia de l'obesitat
Hypoglycemia
Obesity surgery
topic Hipoglucèmia
Cirurgia de l'obesitat
Hypoglycemia
Obesity surgery
description Background: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. Methods: Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. Results: Over 11 years of follow-up, 22 patients were identified. The test most used to provoke hypoglycemia was the oral glucose load test followed by the mixed meal test which was the least standardized test. With pharmacological treatment, 3 patients were symptom-free (with octreotide) and in 12 patients hypoglycemic episodes were attenuated. Seven patients had persistent hypoglycemic episodes and underwent surgery. Partial pancreatectomy was performed in 3 patients who had positive selective arterial calcium stimulation, and nesidioblastosis was confirmed in 2 patients. Reconversion to normal anatomy was performed in 3 patients, and 1 patient underwent a resection of the 'candy cane' roux limb, with resolution of hypoglycemia in all cases. Conclusions: There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not respond to pharmacological treatment, reconstruction of gastrojejunal continuity may be the safest and most successful procedure.
publishDate 2016
dc.date.none.fl_str_mv 2016
2018
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/126907
url https://hdl.handle.net/2445/126907
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1159/000442764
Obesity Facts, 2016, vol. 9, num. 1, p. 41-51
https://doi.org/10.1159/000442764
dc.rights.none.fl_str_mv cc by-nc (c) Karger, 2016
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Karger, 2016
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11 p.
application/pdf
dc.publisher.none.fl_str_mv Karger
publisher.none.fl_str_mv Karger
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869411156956807168
score 15.812429

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