Evidence mapPaperPMID 33974064Full record

ArticleThe Journal of clinical endocrinology and metabolism2021

Glycemic Patterns Are Distinct in Post-Bariatric Hypoglycemia After Gastric Bypass (PBH-RYGB).

Daniel Lee, Jonathan M Dreyfuss, Amanda Sheehan, Alexa Puleio, Christopher M Mulla, Mary Elizabeth Patti

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

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  4. Influence of dietary intake and eating patterns on reactive hypoglycemic events in patients postesophagectomy: A prospective observational study using continuous glucose monitoring.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
    Observational
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  15. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Daniel LeeResearch Division, Joslin Diabetes Center, Boston 02215, MA, USA.
Jonathan M DreyfussResearch Division, Joslin Diabetes Center, Boston 02215, MA, USA.
Amanda SheehanResearch Division, Joslin Diabetes Center, Boston 02215, MA, USA.
Alexa PuleioResearch Division, Joslin Diabetes Center, Boston 02215, MA, USA.
Christopher M MullaResearch Division, Joslin Diabetes Center, Boston 02215, MA, USA.
Mary Elizabeth PattiResearch Division, Joslin Diabetes Center, Boston 02215, MA, USA.ORCID 0000-0002-8163-3429
Joslin Diabetes Center · US

Funding

PILOT STUDY--SECRETORY TARGETING IN PANCREATIC B CELLSP30DK036836 · JOSLIN DIABETES CENTER · 1986 to 2025
$12.1M
TRAINING IN DIABETES AND METABOLISMT32DK007260 · JOSLIN DIABETES CENTER · 1986 to 2025
$2.6M
Alliance of Randomized Trials of Medicine vs Metabolic Surgery in Type 2 Diabetes - (ARMMS-T2D)U01DK114156 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI ALI AMINIAN, JOHN P. KIRWAN · 2022 to 2022
$1.3M
NCATS NIH HHS UL 1TR002541NIDDK NIH HHS P30 DK036836NIDDK NIH HHS R01 DK106193NIDDK NIH HHS R01 DK121995NIDDK NIH HHS T32 DK007260NIDDK NIH HHS U01 DK114156NIH HHS UL 1TR002541
6 · The paper itself

Abstract

contextSevere hypoglycemia with neuroglycopenia, termed post-bariatric hypoglycemia (PBH). typically occurs postprandially, but it is also reported after activity or mid-nocturnally.

objectiveTo quantify glycemia, glycemic variability, and magnitude/duration of low sensor glucose (SG) values in patients with PBH after Roux-en-Y gastric bypass (PBH-RYGB).

methodsThis retrospective analysis of data from an academic medical center included individuals with PBH-RYGB (n = 40), reactive hypoglycemia without gastrointestinal surgery (Non-Surg Hypo, n = 20), prediabetes (Pre-DM, n = 14), newly diagnosed T2D (n = 5), and healthy controls (HC, n = 38). Masked continuous glucose monitoring (Dexcom G4) was used to assess patterns over 24 hours, daytime (6 am-midnight) and nighttime (midnight-6 am). Prespecified measures included mean and median SG, variability, and percent time at thresholds of sensor glucose.

resultsMean and median SG were similar for PBH-RYGB and HC (mean: 99.8 ± 18.6 vs 96.9 ± 10.2 mg/dL; median: 93.0 ± 14.8 vs 94.5 ± 7.4 mg/dL). PBH-RYGB had a higher coefficient of variation (27.3 ± 6.8 vs 17.9 ± 2.4%, P < 0.0001) and range (154.5 ± 50.4 vs 112.0 ± 26.7 mg/dL, P < 0.0001). Nadir was lowest in PBH-RYGB (42.5 ± 3.7 vs HC 49.0 ± 11.9 mg/dL, P = 0.0046), with >2-fold greater time with SG < 70 mg/dL vs HC (7.7 ± 8.4 vs 3.2 ± 4.1%, P = 0.0013); these differences were greater at night (12.6 ± 16.9 vs 1.0 ± 1.5%, P < 0.0001). Non-Surg Hypo also had 4-fold greater time with SG < 70 at night vs HC (SG < 70: 4.0 ± 5.9% vs 1.0 ± 1.5%), but glycemic variability was not increased.

conclusionPatients with PBH-RYGB experience higher glycemic variability and frequency of SG < 70 compared to HC, especially at night. These data suggest that additional pathophysiologic mechanisms beyond prandial changes contribute to PBH.

Indexed as

AdultBlood GlucoseBlood Glucose Self-MonitoringFemaleGastric BypassHumansHypoglycemiaMaleMiddle AgedPostoperative ComplicationsPostprandial PeriodRetrospective StudiesBlood Glucosebariatric (metabolic) surgerydiabeteshypoglycemia

Identifiers

PMID33974064
PMCPMC8277212
OpenAlexW3161187331

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.