Marie Pigeyre1, Charlotte Vaurs2, Violeta Raverdy3, Hélène Hanaire2, Patrick Ritz4, François Pattou3. 1. Inserm U859, Biotherapy Diabetes, Department of Nutrition, University of Lille, CHRU Lille, Lille, France. 2. Cardiovascular and Metabolic Disease Department, CHU de Toulouse, Toulouse, France. 3. Inserm U859, Biotherapy Diabetes, Department of General and Endocrine Surgery, University of Lille, CHRU Lille, Lille, France. 4. Cardiovascular and Metabolic Disease Department, CHU de Toulouse, Toulouse, France; Inserm UMR 1027, Université Paul Sabatier, Université de Toulouse 3, Toulouse, France. Electronic address: Patrick.ritz@wanadoo.fr.
Abstract
BACKGROUND: Hypoglycemic episodes are described after bariatric surgery. OBJECTIVE: To report the prevalence of hypoglycemia after a 75 g oral glucose load (OGTT) after Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (LAGB), and to identify predicting factors. SETTING: Bariatric surgery referral center. METHODS: Prospective cohort of 351 consecutive patients before and 12 months after bariatric surgery, on whom an OGTT was performed. The main outcome measure was postchallenge hypoglycemia (PCHy), defined as a 120 minute plasma glucose value<2.8 mmol/L (50.4 mg/dL). RESULTS: Only patients with an RYGB presented with PCHy. It occurred in 23 patients or a prevalence of 10.4% after an RYGB. The OR was 25.5 (95% CI 3.4-191; P<.001) compared with before surgery. Patients with PCHy after surgery had a lower glycated hemoglobin (HbA1c), and a lower 2-hour postchallenge value before surgery. Before surgery, patients with normal glucose tolerance had an increased risk of PCHy after surgery (OR 8.6, 95% CI 2.0-37.6; P< .001). CONCLUSIONS: The prevalence of OGTT-induced hypoglycemia is increased 25.5 times, 12 months after an RYGB. This is not observed after a gastric banding.
BACKGROUND: Hypoglycemic episodes are described after bariatric surgery. OBJECTIVE: To report the prevalence of hypoglycemia after a 75 g oral glucose load (OGTT) after Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (LAGB), and to identify predicting factors. SETTING: Bariatric surgery referral center. METHODS: Prospective cohort of 351 consecutive patients before and 12 months after bariatric surgery, on whom an OGTT was performed. The main outcome measure was postchallenge hypoglycemia (PCHy), defined as a 120 minute plasma glucose value<2.8 mmol/L (50.4 mg/dL). RESULTS: Only patients with an RYGB presented with PCHy. It occurred in 23 patients or a prevalence of 10.4% after an RYGB. The OR was 25.5 (95% CI 3.4-191; P<.001) compared with before surgery. Patients with PCHy after surgery had a lower glycated hemoglobin (HbA1c), and a lower 2-hour postchallenge value before surgery. Before surgery, patients with normal glucose tolerance had an increased risk of PCHy after surgery (OR 8.6, 95% CI 2.0-37.6; P< .001). CONCLUSIONS: The prevalence of OGTT-induced hypoglycemia is increased 25.5 times, 12 months after an RYGB. This is not observed after a gastric banding.
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