ReviewJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2011
Advances in the etiology and management of hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass.
Review in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.
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Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Interdisciplinary European guidelines on metabolic and bariatric surgery.Obesity surgery · 2014Guideline
- Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery.Obesity (Silver Spring, Md.) · 2013Guideline
- Interdisciplinary European Guidelines on metabolic and bariatric surgery.Obesity facts · 2013Guideline
- Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsGuideline
- Post-Gastric Bypass Hyperinsulinemic Hypoglycemia: Fructose is a Carbohydrate Which Can Be Safely Consumed.The Journal of clinical endocrinology and metabolism · 2015Trial
- Effect of carbohydrate restriction in patients with hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass.Obesity surgery · 2014Trial
- Response to glucose tolerance testing and solid high carbohydrate challenge: comparison between Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and duodenal switch.Surgical endoscopy · 2014Trial
- Medically Refractory Nesidioblastosis as a Late Adverse Effect of Roux-en-Y Gastric Bypass.Cureus · 2025Article
- Article
- Beyond diabetes remission a step further: Post bariatric surgery hypoglycemia.World journal of diabetes · 2022Article
- An unusual presentation of post gastric bypass hypoglycemia with both postprandial and fasting hypoglycemiaEndocrinology, diabetes & metabolism case reports · 2018Article
- Article
- [Metabolic surgery or conservative measures as therapy of obese type 2 diabetics?]Wiener medizinische Wochenschrift (1946) · 2017Review
- The treatment of hyperinsulinemic hypoglycaemia in adults: an update.Journal of endocrinological investigation · 2017Review
- The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus and the Management of Hypoglycemic Events.Frontiers in endocrinology · 2017Review
- Article
- Post-Gastric Bypass Hypoglycemia.Current diabetes reports · 2016Review
- Nutritional and Protein Deficiencies in the Short Term following Both Gastric Bypass and Gastric Banding.PloS one · 2016Article
- Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry.Obesity facts · 2016Article
- Total pancreatectomy for the management of refractory post-gastric bypass hypoglycemia.Digestive diseases and sciences · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHyperinsulinemic hypoglycemia with severe neuroglycopenia has been identified as a late complication of Roux-en-Y gastric bypass (RYGB) in a small number of patients. DISCUSSION: The rapid resolution of type 2 diabetes mellitus after RYGB is probably related to increased secretion of the incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), and patients with post-RYGB hypoglycemia demonstrate prolonged elevations of GIP and GLP-1 compared to non-hypoglycemic post-RYGB patients. Nesidioblastosis has been identified in some patients with post-RYGB hypoglycemia and is likely due to the trophic effects of GIP and GLP-1 on pancreatic islets.
conclusionsTreatment of hypoglycemia after RYGB should begin with strict dietary (low carbohydrate) alteration and may require a trial of diazoxide, octreotide, or calcium-channel antagonists, among other drugs. Surgical therapy should include consideration of a restrictive form of bariatric procedure, with or without reconstitution of gastrointestinal continuity. Partial or total pancreatic resection should be avoided.
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Registered trials
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