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. 2015 May;23(5):1079-84.
doi: 10.1002/oby.21042. Epub 2015 Apr 10.

Prevalence of and risk factors for hypoglycemic symptoms after gastric bypass and sleeve gastrectomy

Clare J Lee  1 , Jeanne M Clark, Michael Schweitzer, Thomas Magnuson, Kimberley Steele, Olivia Koerner, Todd T Brown
Affiliations

Prevalence of and risk factors for hypoglycemic symptoms after gastric bypass and sleeve gastrectomy

Clare J Lee et al. Obesity (Silver Spring). 2015 May.

Abstract

Objective: To determine the prevalence of and risk factors for postprandial hypoglycemic symptoms among bariatric surgery patients.

Methods: A questionnaire including the Edinburgh hypoglycemia scale was mailed to patients who underwent either Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG) at a single center. Based on the questionnaire, the patients were categorized as having high or low suspicion for post surgical, postprandial hypoglycemic symptoms.

Results: Of the 1119 patients with valid addresses, 40.2% (N = 450) responded. Among the respondents, 34.2% had a high suspicion for symptoms of post bariatric surgery hypoglycemia. In multivariate analyses, in addition to female sex (P = 0.001), RYGB (P = 0.004), longer time since surgery (P = 0.013), and lack of diabetes (P = 0.040), the high suspicion group was more likely to report pre-operative symptoms of hypoglycemia (P < 0.001), compared to the low suspicion group. Similar results were observed when the high suspicion group was restricted to those requiring assistance from others, syncope, seizure with severe symptoms, or medically confirmed hypoglycemia (N = 52).

Conclusions: One third of patients who underwent RYGB or VSG reported postprandial symptoms concerning for postsurgical hypoglycemia, which was related to the presence of pre-operative hypoglycemic symptoms. Pre-operative screening for hypoglycemic symptoms may identify a group of patients at increased risk of postbariatric surgery hypoglycemia.

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Conflict of interest statement

Conflicts of interest: The authors have no competing interests.

Figures

Figure 1
Figure 1
Odds of post-bariatric surgery hypoglycemic symptoms in (A) high suspicion group* (N=154) compared to those not in the high suspicion group and in (B) those with severe or medically confirmed hypoglycemia (N=52) compared to those without such history *High suspicion group: Those with 3 or more symptoms of hypoglycemia or a history of severe hypoglycemia requiring assistance, seizure or medical diagnosis of hypoglycemia following bariatric surgery
See this image and copyright information in PMC

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