Jorick van Meijeren1, Ilse Timmer2, Hans Brandts3, Ignace Janssen4, Hans de Boer2. 1. Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands. Electronic address: jorickvm@gmail.com. 2. Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands. 3. Department of Clinical Nutrition, Rijnstate Hospital, Arnhem, the Netherlands. 4. Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
Abstract
BACKGROUND: Up to 15% of patients who have undergone Roux-en-Y gastric bypass (RYGB) surgery may eventually develop symptoms of hypoglycemia. OBJECTIVES: To evaluate the daily life efficacy of a carbohydrate (carb)-restricted dietary advice (CRD) of 6 meals per day with a 30 g carb maximum per meal in patients with documented post-RYGB hypoglycemia. SETTING: Teaching hospital, the Netherlands. METHODS: Frequency and severity of hypoglycemic events before and after CRD were assessed retrospectively in 41 patients with documented post-RYGB hypoglycemia, based on medical records and telephone questionnaires. Hypoglycemia was defined as a blood glucose level<3.0 mmol/L. Results are expressed as mean values±standard error or median and range. RESULTS: CRD decreased the number of hypoglycemic events per month from 17.1 (1.5-180) to 2.5 (0-180), i.e., a decline of 85% (P<.001). The lowest blood glucose measured during a hypoglycemic event increased from 2.1±.4 to 2.6±.2 mmol/L (P = .004). The number of patients who had required outside help in the treatment of hypoglycemia, decreased from 23 to 6 (P<.001). In 14 patients (34.1%) the diet-induced reduction of hypoglycemia was insufficient and required the start of insulin suppressive therapy. CONCLUSION: A CRD, consisting of 6 meals per day with up to 30 g carbs each, is an effective treatment of post-RYGB hypoglycemia in the majority of patients. Additional medication is needed in about a third of patients.
BACKGROUND: Up to 15% of patients who have undergone Roux-en-Y gastric bypass (RYGB) surgery may eventually develop symptoms of hypoglycemia. OBJECTIVES: To evaluate the daily life efficacy of a carbohydrate (carb)-restricted dietary advice (CRD) of 6 meals per day with a 30 g carb maximum per meal in patients with documented post-RYGB hypoglycemia. SETTING: Teaching hospital, the Netherlands. METHODS: Frequency and severity of hypoglycemic events before and after CRD were assessed retrospectively in 41 patients with documented post-RYGB hypoglycemia, based on medical records and telephone questionnaires. Hypoglycemia was defined as a blood glucose level<3.0 mmol/L. Results are expressed as mean values±standard error or median and range. RESULTS:CRD decreased the number of hypoglycemic events per month from 17.1 (1.5-180) to 2.5 (0-180), i.e., a decline of 85% (P<.001). The lowest blood glucose measured during a hypoglycemic event increased from 2.1±.4 to 2.6±.2 mmol/L (P = .004). The number of patients who had required outside help in the treatment of hypoglycemia, decreased from 23 to 6 (P<.001). In 14 patients (34.1%) the diet-induced reduction of hypoglycemia was insufficient and required the start of insulin suppressive therapy. CONCLUSION: A CRD, consisting of 6 meals per day with up to 30 g carbs each, is an effective treatment of post-RYGB hypoglycemia in the majority of patients. Additional medication is needed in about a third of patients.
Authors: Ana Raquel Marques; Carolina B Lobato; Sofia S Pereira; Marta Guimarães; Sandra Faria; Mário Nora; Mariana P Monteiro Journal: Obes Surg Date: 2020-01 Impact factor: 4.129
Authors: Katja A Schönenberger; Luca Cossu; Francesco Prendin; Giacomo Cappon; Jing Wu; Klaus L Fuchs; Simon Mayer; David Herzig; Andrea Facchinetti; Lia Bally Journal: Front Nutr Date: 2022-04-07
Authors: Carolina B Lobato; Sofia S Pereira; Marta Guimarães; Tiago Morais; Pedro Oliveira; Jorge P M de Carvalho; Mário Nora; Mariana P Monteiro Journal: Sci Rep Date: 2020-07-06 Impact factor: 4.379