Abstract

As the prevalence of bariatric procedures increases, an important phenomenon to consider is post-gastric bypass hypoglycemia (PBH). PBH is defined as a post-prandial plasma glucose < 55 mg/dL accompanied by adrenergic and/or neuroglycopenic symptoms that are resolved by carbohydrate intake. PBH is explained by multiple mechanisms: increased GLP-1 secretion, inappropriate insulin release, reduced insulin clearance, and impaired glucagon counter-regulation. Although rare, PBH can be very serious and distressing to patients due to the symptom burden and difficulty to manage.

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