Relationship between biochemical and symptomatic hypoglycemia after RYGB. Responses to a mixed meal test: a case-control study
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Relationship between biochemical and symptomatic hypoglycemia after RYGB. Responses to a mixed meal test : a case-control study. / Søeby, Mette; Nielsen, Joan B.; Pedersen, Steen B.; Gribsholt, Sigrid B.; Holst, Jens J.; Richelsen, Bjørn.
I: Surgery for Obesity and Related Diseases, Bind 16, Nr. 9, 2020, s. 1179-1185.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Relationship between biochemical and symptomatic hypoglycemia after RYGB. Responses to a mixed meal test
T2 - a case-control study
AU - Søeby, Mette
AU - Nielsen, Joan B.
AU - Pedersen, Steen B.
AU - Gribsholt, Sigrid B.
AU - Holst, Jens J.
AU - Richelsen, Bjørn
PY - 2020
Y1 - 2020
N2 - Background: Postprandial hypoglycemia is a relatively common complication after Roux-en-Y gastric bypass (RYGB). The cause remains incompletely understood, and the association between biochemical hypoglycemia and hypoglycemic symptoms is unclear.Objectives: To evaluate the association between postprandial hormonal responses and biochemical and symptomatic hypoglycemia after RYGB.Setting: University Hospital, Denmark.Methods: A case-control study with 3 groups: (1) RYGB group with postprandial hypoglycemic symptoms (HS), n = 13; (2) RYGB-group with no symptoms of hypoglycemia (NHS), n = 13; and (3) nonoperated body mass index-matched controls (CON), n = 7. Plasma glucose (PG) and hormonal responses (insulin, glucagon-like peptide-1, gastric inhibitory polypeptide, glucagon) were measured after a mixed meal test (MMT), and hypoglycemic symptoms were determined by a questionnaire. The primary outcomes were differences in subjective and biochemical responses related to hypoglycemia among the 3 groups.Results: Nadir PG was lower (3.1 versus 4.0 mmol/L (56 versus 72 mg/dL); P = .0002) and peak insulin higher in HS than NHS patients (1073 versus 734 pmol/L; P = .0499). Of the 13 patients with a peak insulin >850 pmol/L, 8 patients developed symptoms whereas only 2 out of the 13 patients with peak insulin 3 mmol/L (54 mg/dL) revealed a difference in both peak insulin (1138 versus 760 pmol/L; P = .042) and peak glucagon-like peptide-1 (182 versus 86 pmol/L; P = .016) concentrations.Conclusions: Patients with HS had lower nadir PG and higher insulin responses than NHS patients after MMT. Regarding PG, PG
AB - Background: Postprandial hypoglycemia is a relatively common complication after Roux-en-Y gastric bypass (RYGB). The cause remains incompletely understood, and the association between biochemical hypoglycemia and hypoglycemic symptoms is unclear.Objectives: To evaluate the association between postprandial hormonal responses and biochemical and symptomatic hypoglycemia after RYGB.Setting: University Hospital, Denmark.Methods: A case-control study with 3 groups: (1) RYGB group with postprandial hypoglycemic symptoms (HS), n = 13; (2) RYGB-group with no symptoms of hypoglycemia (NHS), n = 13; and (3) nonoperated body mass index-matched controls (CON), n = 7. Plasma glucose (PG) and hormonal responses (insulin, glucagon-like peptide-1, gastric inhibitory polypeptide, glucagon) were measured after a mixed meal test (MMT), and hypoglycemic symptoms were determined by a questionnaire. The primary outcomes were differences in subjective and biochemical responses related to hypoglycemia among the 3 groups.Results: Nadir PG was lower (3.1 versus 4.0 mmol/L (56 versus 72 mg/dL); P = .0002) and peak insulin higher in HS than NHS patients (1073 versus 734 pmol/L; P = .0499). Of the 13 patients with a peak insulin >850 pmol/L, 8 patients developed symptoms whereas only 2 out of the 13 patients with peak insulin 3 mmol/L (54 mg/dL) revealed a difference in both peak insulin (1138 versus 760 pmol/L; P = .042) and peak glucagon-like peptide-1 (182 versus 86 pmol/L; P = .016) concentrations.Conclusions: Patients with HS had lower nadir PG and higher insulin responses than NHS patients after MMT. Regarding PG, PG
KW - Roux-en-Y gastric bypass
KW - Hypoglycemia
KW - Insulin
KW - Glucagon-like peptide-1
KW - Mixed meal test
KW - GASTRIC-BYPASS-SURGERY
KW - BARIATRIC SURGERY
KW - ORAL GLUCOSE
KW - NEUROGLYCOPENIA
KW - PREVALENCE
KW - SECRETION
KW - INCRETIN
KW - GLP-1
U2 - 10.1016/j.soard.2020.04.024
DO - 10.1016/j.soard.2020.04.024
M3 - Journal article
C2 - 32576515
VL - 16
SP - 1179
EP - 1185
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
SN - 1550-7289
IS - 9
ER -
ID: 250118045