ArticleThe Journal of clinical endocrinology and metabolism2021
Glycemic Patterns Are Distinct in Post-Bariatric Hypoglycemia After Gastric Bypass (PBH-RYGB).
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.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- European guideline on obesity care in patients with gastrointestinal and liver diseases - Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline.United European gastroenterology journal · 2022Guideline
- Acarbose or Canagliflozin vs. Placebo to Ameliorate Post-Bariatric Hypoglycaemia: The Clinical Outcomes of the HypoBar I Randomised Clinical Trial.Diabetes, obesity & metabolism · 2026Trial
- Continuous glucose monitoring in patients with post-bariatric hypoglycaemia reduces hypoglycaemia and glycaemic variability.Diabetes, obesity & metabolism · 2023Trial
- 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 · 2026Observational
- Post-bariatric Hypoglycemia Management: A Gulf Cooperation Council Consensus Statement.Journal of the Endocrine Society · 2026Article
- A personalized and automated real-time meal detection algorithm based on continuous glucose monitoring and heart rate data for individuals with post-bariatric hypoglycemia.Frontiers in digital health · 2026Article
- 8. Obesity and Weight Management for the Prevention and Treatment of Diabetes: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- CGM profiling in Roux-en-Y gastric bypass, type 1 diabetes and healthy adults: Unmasking deviations from normoglycaemia.Diabetes, obesity & metabolism · 2025Article
- International expert consensus on surgery for type 2 diabetes mellitus.BMC endocrine disorders · 2025Review
- 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- Associations of hemoglobin trajectories and time in target hemoglobin range with adverse pregnancy outcomes: a real-world pregnancy records-based study.Frontiers in global women's health · 2025Article
- Postprandial metabolomics analysis reveals disordered serotonin metabolism in post-bariatric hypoglycemia.The Journal of clinical investigation · 2024Article
- Latent Autoimmune Diabetes in Adults Following Bariatric Surgery-Induced Hypoglycemia in a 36-Year-Old Woman.Cureus · 2024Article
- Continuous Glucose Monitoring Captures Glycemic Variability After Roux-en-Y Gastric Bypass in Patients with and Without Type 2 Diabetes Mellitus: A Prospective Cohort Study.Obesity surgery · 2024Article
- Increased glycemic variability in pregnant women with Roux-en-Y gastric bypass compared with sleeve gastrectomy.BMJ open diabetes research & care · 2024Observational
- 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- The impact of maternal bariatric surgery on long-term health of offspring: a scoping review.Pediatric research · 2023Article
- Use of Continuous Glucose Monitoring in Patients Following Bariatric Surgery: A Scoping Review.Obesity surgery · 2023Article
- Mixed Meal Tolerance Test Versus Continuous Glucose Monitoring for an Effective Diagnosis of Persistent Post-Bariatric Hypoglycemia.Journal of clinical medicine · 2023Article
- Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
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.
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