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Obes Surg. 2009 Nov;19(11):1550-6. doi: 10.1007/s11695-009-9893-8. Epub 2009 Jun 26.

Plasma glucose and insulin regulation is abnormal following gastric bypass surgery with or without neuroglycopenia.

Author information

1
Department of Medicine, Stanford University Medical Center, 300 Pasteur Drive, Room S025, Stanford, CA 94305-5103, USA. sunhkim@stanford.edu

Abstract

BACKGROUND:

Enhanced insulin sensitivity is commonly seen following Roux-en-Y gastric bypass surgery (RYGB) whereas symptomatic hypoglycemia post-RYGB seems to occur infrequently. It is unclear how different plasma glucose and insulin responses are in patients with symptomatic hypoglycemia (SX-RYGB) versus those who remain asymptomatic (ASX-RYGB), nor when compared with non-surgical controls with varying degrees of insulin sensitivity.

METHODS:

Plasma glucose and insulin concentrations were determined following a 75-g oral glucose challenge in five groups: symptomatic and asymptomatic patients following RYGB (n = 9 each) and overweight/obese controls, divided into three subgroups (n = 30 each) on the basis of degree of insulin sensitivity measured by the insulin suppression test.

RESULTS:

SX-RYGB group had higher 30-min glucose after oral glucose compared with the ASX-RYGB group (p = 0.04). The two groups did not differ in peak glucose and insulin concentrations, nadir glucose concentration, or insulin-to-glucose ratio 30 min after oral glucose. These values were significantly different from the three control groups, and peak insulin concentrations post-RYGB were increased at every degree of insulin sensitivity as compared with the control groups.

CONCLUSIONS:

Plasma glucose and insulin responses to oral glucose in patients with symptomatic hypoglycemia post-RYGB are minimally different when compared to individuals who remain asymptomatic, and both groups demonstrate hyperinsulinemia out of proportion to their degree of insulin sensitivity.

PMID:
19557485
DOI:
10.1007/s11695-009-9893-8
[Indexed for MEDLINE]

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