Post-Gastric-Bypass Hypoglycemia Successfully Treated with Alpha-Glucosidase Inhibitor Therapy

Publication/Presentation Date

5-2013

Abstract

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.

Volume

19

Issue

3

First Page

511

Last Page

514

ISSN

1934-2403

Disciplines

Endocrinology, Diabetes, and Metabolism | Medical Sciences | Medical Specialties | Medicine and Health Sciences

PubMedID

23337151

Department(s)

Department of Medicine, Department of Medicine Fellows and Residents

Document Type

Article

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