Risk of post-gastric bypass surgery hypoglycemia in nondiabetic individuals: A single center experience.

Abstract

OBJECTIVE:

The epidemiology of post-gastric bypass surgery hypoglycemia (PGBH) is incompletely understood. This study aimed to evaluate the risk of PGBH among nondiabetic patients and associated factors.

METHODS:

A cohort study of nondiabetic patients who underwent Roux-en-Y gastric bypass (RYGB) was conducted. PGBH was defined by any postoperative record of glucose < 60 mg/dL, diagnosis of hypoglycemia, or any medication use for treatment of PGBH. Kaplan-Meier analysis was used to describe PGBH occurrence, log-rank tests, and Cox regression to examine associated factors.

RESULTS:

Of the 1,206 eligible patients, 86% were female with mean age of 43.7 years, mean preoperative BMI of 48.7 kg/m(2) , and a mean follow-up of 4.8 years. The cumulative incidence of hypoglycemia at 1 and 5 years post-RYGB was 2.7% and 13.3%, respectively. Incidence of PGBH was identified in 158 patients and was associated with lower preoperative BMI (P = 0.048), lower preoperative HbA1c (P = 0.012), and higher 6-month percent of excess body weight loss (%EWL) (P = 0.001). A lower preoperative HbA1c (HR = 1.73, P = 0.0034) and higher 6-month %EWL (HR = 1.96, P = 0.0074) remained independently correlated with increased risk for PGBH in multi-regression analysis.

CONCLUSIONS:

The 5-year incidence of PGBH among nondiabetic individuals was 13.3% and was associated with a lower preoperative HbA1c and greater weight loss at 6 months following surgery.

• Authors: Clare J Lee, G Craig Wood, Mariana Lazo, Todd T Brown, Jeanne M Clark, Christopher Still, Peter Benotti
• Journal: Obesity (Silver Spring, Md.) (Obesity (Silver Spring)) Vol. 24 Issue 6 Pg. 1342-8 (06 2016) ISSN: 1930-739X [Electronic] United States
• PMID: 27225597 (Publication Type: Journal Article)
• Copyright: © 2016 The Obesity Society.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A

Topics

• Adult
• Blood Glucose (metabolism)
• Body Mass Index
• Cohort Studies
• Female
• Follow-Up Studies
• Gastric Bypass (adverse effects)
• Glycated Hemoglobin (metabolism)
• Humans
• Hypoglycemia (blood, epidemiology, etiology)
• Incidence
• Male
• Middle Aged
• Obesity, Morbid (surgery)
• Postoperative Period
• Proportional Hazards Models
• Risk Factors
• Weight Loss