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 language | English |
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Pages (from-to) | 843-856 |
Number of pages | 14 |
Journal | Obesity Reviews |
Volume | 16 |
Issue number | 10 |
Early online date | 17-Sept-2015 |
DOIs | |
Publication status | Published - 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