Hypoglycemia after Roux-en-Y Gastric Bypass. The Role of Glucagon Like Peptide 1

Abstract

Introduction. Profound hypoglycemia occurs as a late complication in some patients after RYGB. Nesideoblastosis (N) has been found in patients requiring pancreatic resection, and the incretin hormone GLP-1 has been implicated as a cause. We investigated the role of GLP-1 in a 47 year old subject (S) who developed recurrent neuro-glycopenia accompanied by seizures and loss of consciousness 3 years after RYGB. METHODS. A standardized test meal (STM) and 2hr hyperglycemic clamp with GLP-1 infusion (1.5 pmol/kg/min) during the secondhr, before and during a 4 wk trial of octreotide (Oc) (400 ug/day) were administered.