Predictors and weight impact of postbariatric hypoglycemia after Roux-en-Y gastric bypass surgery: a prospective observational cohort study.
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License: CC BY-NC-ND 4.0
State: Public
Version: author
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_6263CAFF4705
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictors and weight impact of postbariatric hypoglycemia after Roux-en-Y gastric bypass surgery: a prospective observational cohort study.
Journal
Surgery for obesity and related diseases
ISSN
1878-7533 (Electronic)
ISSN-L
1550-7289
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Publication Status: aheadofprint
Abstract
Postbariatric hypoglycemia (PBH) is a challenging condition affecting quality of life of patients after bariatric surgery. However, its incidence and predictive factors remain debated.
To determine the incidence of PBH, identify predictors of PBH and assess its association with weight trajectory after bariatric surgery.
University Hospital.
Prospective observational cohort study including 222 nondiabetic patients who underwent Roux-en-Y gastric bypass between 2014 and 2021, had an oral glucose tolerance test (OGTT) and/or A1C (glycated hemoglobin) measurement prior to surgery and were followed for at least 12 months. Diagnosis of PBH was made when symptoms of hypoglycemia were accompanied by a postprandial plasma glucose level < 3.9 mmol/l or a glycemia < 3.9 mmol/l during continuous glucose monitoring, with resolution of symptomatology after carbohydrate consumption. Univariable and multivariable logistic regression analyses were performed to identify factors associated with PBH.
Out of 222 patients, 71 (32%) were diagnosed with PBH. The highest incidence rate was observed at 2 years postbariatric surgery with a cumulative incidence of 26.5%. Predictive factors for higher risk of PBH were younger age at surgery (OR = .97; 95% CI: .94-.99; P = .049) and early dumping syndrome (OR = 3.05; 95% CI: 1.62-6.04; P = .0008). In multivariable logistic regression, higher glycemia at 2 hours during preoperative OGTT was associated with lower risk of PBH (OR = .8; 95% CI: .63-.98; P = .04). PBH was not associated with weight trajectory after surgery in our cohort.
Younger age at time of surgery and lower blood glucose at 120 minute during preoperative OGTT are risk factors for PBH. Early dumping syndrome is significantly associated with PBH and could be used as a red flag to help identify patients at risk of PBH.
To determine the incidence of PBH, identify predictors of PBH and assess its association with weight trajectory after bariatric surgery.
University Hospital.
Prospective observational cohort study including 222 nondiabetic patients who underwent Roux-en-Y gastric bypass between 2014 and 2021, had an oral glucose tolerance test (OGTT) and/or A1C (glycated hemoglobin) measurement prior to surgery and were followed for at least 12 months. Diagnosis of PBH was made when symptoms of hypoglycemia were accompanied by a postprandial plasma glucose level < 3.9 mmol/l or a glycemia < 3.9 mmol/l during continuous glucose monitoring, with resolution of symptomatology after carbohydrate consumption. Univariable and multivariable logistic regression analyses were performed to identify factors associated with PBH.
Out of 222 patients, 71 (32%) were diagnosed with PBH. The highest incidence rate was observed at 2 years postbariatric surgery with a cumulative incidence of 26.5%. Predictive factors for higher risk of PBH were younger age at surgery (OR = .97; 95% CI: .94-.99; P = .049) and early dumping syndrome (OR = 3.05; 95% CI: 1.62-6.04; P = .0008). In multivariable logistic regression, higher glycemia at 2 hours during preoperative OGTT was associated with lower risk of PBH (OR = .8; 95% CI: .63-.98; P = .04). PBH was not associated with weight trajectory after surgery in our cohort.
Younger age at time of surgery and lower blood glucose at 120 minute during preoperative OGTT are risk factors for PBH. Early dumping syndrome is significantly associated with PBH and could be used as a red flag to help identify patients at risk of PBH.
Keywords
Early dumping syndrome, Gastric bypass surgery, Hypoglycemia
Pubmed
Open Access
Yes
Create date
09/08/2024 14:15
Last modification date
20/08/2024 6:29