OBJECTIVE: To review the effectiveness of alpha-glucosidase inhibitor (AGI) therapy in the treatment of hypoglycemia after Roux-en-y gastric surgery. METHODS: Retrospective case review. RESULTS: Four patients who previously underwent Roux-en-y gastric bypass were evaluated because of severe symptomatic postprandial hypoglycemia that was unresponsive to a low-carbohydrate diet. Mixed-meal testing confirmed hyperinsulinemia. Other causes of hypoglycemia were ruled out by a combination of clinical examination, endocrine testing, and computed tomography imaging. Symptomatic hypoglycemia resolved in all 4 patients after AGI therapy was started. One patient could not tolerate long-term therapy because of a rash. The other 3 patients were followed for between 5 and 48 months and remained free of symptomatic postprandial hypoglycemia. CONCLUSION: AGI therapy is effective in the long-term treatment of post-Roux-en-y hypoglycemia in patients unresponsive to a low-carbohydrate diet. To our knowledge, this is the first report documenting the long-term usefulness of this therapy in a series of patients.
OBJECTIVE: To review the effectiveness of alpha-glucosidase inhibitor (AGI) therapy in the treatment of hypoglycemia after Roux-en-y gastric surgery. METHODS: Retrospective case review. RESULTS: Four patients who previously underwent Roux-en-y gastric bypass were evaluated because of severe symptomatic postprandial hypoglycemia that was unresponsive to a low-carbohydrate diet. Mixed-meal testing confirmed hyperinsulinemia. Other causes of hypoglycemia were ruled out by a combination of clinical examination, endocrine testing, and computed tomography imaging. Symptomatic hypoglycemia resolved in all 4 patients after AGI therapy was started. One patient could not tolerate long-term therapy because of a rash. The other 3 patients were followed for between 5 and 48 months and remained free of symptomatic postprandial hypoglycemia. CONCLUSION: AGI therapy is effective in the long-term treatment of post-Roux-en-y hypoglycemia in patients unresponsive to a low-carbohydrate diet. To our knowledge, this is the first report documenting the long-term usefulness of this therapy in a series of patients.
Authors: Nuria Vilarrasa; Albert Goday; Miguel Angel Rubio; Assumpta Caixàs; Silvia Pellitero; Andrea Ciudin; Alfonso Calañas; José Ignacio Botella; Irene Bretón; María José Morales; María Jesús Díaz-Fernández; Pedro Pablo García-Luna; Albert Lecube Journal: Obes Facts Date: 2016-02-23 Impact factor: 3.942