Advertisement

Obesity Surgery

, Volume 19, Issue 9, pp 1333–1334 | Cite as

Successful Medical Management of Status Post-Roux-en-Y-Gastric-Bypass Hyperinsulinemic Hypoglycemia

  • Elias Spanakis
  • Claudia GragnoliEmail author
Case Report

Abstract

Roux-en-Y gastric bypass (RYGBP) is the most commonly performed type of bariatric surgery, which is used in the treatment of obesity and type 2 diabetes. Recent case reports and case series have described a rare complication of RYGBP, status post-gastric-bypass hyperinsulinemic hypoglycemia, which was mainly managed successfully with pancreatectomy. In this letter, we describe the first successful management of status post-gastric-bypass hyperinsulinemic hypoglycemia with diazoxide.

Keywords

Bariatric T2D Obesity Hypoglycemia Diazoxide Gastric bypass Hyperinsulinemic hypoglycemia RYGBP Type 2 diabetes 

Notes

Acknowledgments

This study was made possible by the Penn State University Physician–Scientist Stimulus Award and by the Dean’s Pilot and Feasibility Grant, number D1BTH06321-01, from the Office for the Advancement of Telehealth (OAT), Health Resources and Services Administration, DHHS. This project is funded, in part, under a grant from the Pennsylvania Department of Health using Tobacco Settlement Funds. The department specifically disclaims responsibility for any analyses, interpretations, or conclusions.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

References

  1. 1.
    Spanakis E, Gragnoli C. Bariatric surgery, safety and type 2 diabetes. Obes Surg. 2008;19:363–8.CrossRefGoogle Scholar
  2. 2.
    American Society of Bariatric Surgery. Brief history and summary of bariatric surgery (Chapter 3). Gainesville: American Society of Bariatric Surgery; 2005. http://www.asbs.org/html/patients/bypass.html.Google Scholar
  3. 3.
    Service GJ, Thompson GB, Service FJ, et al. Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med. 2005;353(3):249–54.CrossRefGoogle Scholar
  4. 4.
    Wax JR, Heersink D, Pinette MG, et al. Symptomatic hypoglycemia complicating pregnancy following Roux-en-Y gastric bypass surgery. Obes Surg. 2007;17(5):698–700.CrossRefGoogle Scholar
  5. 5.
    Bantle JP, Ikramuddin S, Kellogg TA, et al. Hyperinsulinemic hypoglycemia developing late after gastric bypass. Obes Surg. 2007;17(5):592–4.CrossRefGoogle Scholar
  6. 6.
    Patti ME, McMahon G, Mun EC, et al. Severe hypoglycaemia post-gastric bypass requiring partial pancreatectomy: evidence for inappropriate insulin secretion and pancreatic islet hyperplasia. Diabetologia. 2005;48(11):2236–40.CrossRefGoogle Scholar
  7. 7.
    Alvarez GC, Faria EN, Beck M, et al. Laparoscopic spleen-preserving distal pancreatectomy as treatment for nesidioblastosis after gastric bypass surgery. Obes Surg. 2007;17(4):550–2.CrossRefGoogle Scholar
  8. 8.
    Clancy TE, Moore FD Jr, Zinner MJ. Post-gastric bypass hyperinsulinism with nesidioblastosis: subtotal or total pancreatectomy may be needed to prevent recurrent hypoglycemia. J Gastrointest Surg. 2006;10(8):1116–9.CrossRefGoogle Scholar
  9. 9.
    Hussain K. Diagnosis and management of hyperinsulinaemic hypoglycaemia of infancy. Horm Res. 2008;69(1):2–13.PubMedGoogle Scholar
  10. 10.
    Moreira RO, Moreira RB, Machado NA, et al. Post-prandial hypoglycemia after bariatric surgery: pharmacological treatment with verapamil and acarbose. Obes Surg. 2008;18(12):1618–21.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2009

Open AccessThis is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (https://creativecommons.org/licenses/by-nc/2.0), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  1. 1.Laboratory of Molecular Genetics of Complex and Monogenic Disorders, Division of Endocrinology, Diabetes and Metabolism, H044, Department of Medicine and Cellular and Molecular Physiology and Public Health SciencesPenn State Milton S. Hershey Medical CenterHersheyUSA
  2. 2.Penn State University College of MedicineHersheyUSA
  3. 3.Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology and Department of BiologyTemple University’s College of Science and TechnologyPhiladelphiaUSA
  4. 4.Molecular Biology LaboratoryBios Biotech Multi-Diagnostic Health CenterRomeItaly

Personalised recommendations