Post-Gastric-Bypass Hypoglycemia Successfully Treated with Alpha-Glucosidase Inhibitor Therapy
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.
Published In/Presented At
Frankhouser, S., Ahmad, A., Perilli, G., Quintana, B., & Vengrove, M. (2013). Post-gastric-bypass hypoglycemia successfully treated with alpha-glucosidase inhibitor therapy. Endocrine Practice: Official Journal Of The American College Of Endocrinology And The American Association Of Clinical Endocrinologists, 19(3), 511-514. doi:10.4158/EP12281.RA
Endocrinology, Diabetes, and Metabolism | Medical Sciences | Medical Specialties | Medicine and Health Sciences
Department of Medicine, Department of Medicine Fellows and Residents