Diagnostic tools for post-gastric bypass hypoglycaemia

M. Emous*, F. L. Ubels, A. P. van Beek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

49 Citations (Scopus)

Abstract

In spite of its evident success, several late complications can occur after gastric bypass surgery. One of these is post-gastric bypass hypoglycaemia. No evidence-based guidelines exist in the literature on how to confirm the presence of this syndrome. This study aims to describe and compare the tests aimed at making a diagnosis of post-gastric bypass hypoglycaemia and to provide a diagnostic approach based upon the available evidence. A search was conducted in PubMed, Cochrane and Embase. A few questionnaires have been developed to measure the severity of symptoms in post-gastric bypass hypoglycaemia but none has been validated. The gold standard for provocation of a hypoglycaemic event is the oral glucose tolerance test or the liquid mixed meal tolerance test. Both show a high prevalence of hypoglycaemia in post-gastric bypass patients with and without hypoglycaemic complaints as well as in healthy volunteers. No uniformly established cut-off values for glucose concentrations are defined in the literature for the diagnosis of post-gastric bypass hypoglycaemia. For establishing an accurate diagnosis of post-gastric bypass hypoglycaemia, a validated questionnaire, in connection with the diagnostic performance of provocation tests, is the most important thing missing. Given these shortcomings, we provide recommendations based upon the current literature.

Original languageEnglish
Pages (from-to)843-856
Number of pages14
JournalObesity Reviews
Volume16
Issue number10
Early online date17-Sept-2015
DOIs
Publication statusPublished - Oct-2015

Keywords

  • Diagnosis
  • gastric bypass
  • hypoglycaemia
  • GLUCAGON-LIKE PEPTIDE-1
  • GLUCOSE-TOLERANCE TEST
  • AMERICAN-DIABETES-ASSOCIATION
  • DUMPING SYNDROME
  • MIXED MEAL
  • HYPERINSULINEMIC HYPOGLYCEMIA
  • POSTPRANDIAL HYPOGLYCEMIA
  • BARIATRIC SURGERY
  • REACTIVE HYPOGLYCEMIA
  • INSULIN SENSITIVITY

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