ArticleSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery2021
Postbariatric hypoglycemia: symptom patterns and associated risk factors in the Longitudinal Assessment of Bariatric Surgery study.
Article in Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Dumping Syndrome After One Anastomosis Gastric Bypass-A Systematic Review.Obesity surgery · 2025Pooled it
- Incidence and risk factors of post-metabolic and bariatric surgery hypoglycemia: a systematic review.International journal of obesity (2005) · 2025Pooled it
- Continuous glucose monitoring in patients with post-bariatric hypoglycaemia reduces hypoglycaemia and glycaemic variability.Diabetes, obesity & metabolism · 2023Trial
- Long QT syndrome and hypoglycemia in a postbariatric surgery patient with a likely pathogenic variant inJCEM case reports · 2026Article
- Post-Bariatric Hypoglycemia: Diagnosis, Mechanisms and Management-A Case Report-Based Review.Journal of clinical medicine · 2026Review
- Post-bariatric Hypoglycemia Management: A Gulf Cooperation Council Consensus Statement.Journal of the Endocrine Society · 2026Article
- 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- β-Cell Mass in Individuals With and Without Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass.Diabetes · 2025Article
- Predictors of Post-Bariatric Surgery Hypoglycemia: A Multicenter Retrospective Cohort Study.Endocrinology, diabetes & metabolism · 2025Article
- Remission of type 2 diabetes one year after esophagectomy with gastric conduit reconstruction: A prospective cohort study.World journal of gastrointestinal surgery · 2025Article
- Adverse Health Outcomes Associated with Hypoglycemia Following Bariatric Surgery.Metabolic syndrome and related disorders · 2025Article
- Defining Clinical Characteristics of Individuals With and Without Post-Bariatric Hypoglycemia After Gastric Bypass.Clinical endocrinology · 2025Observational
- Postprandial metabolomics analysis reveals disordered serotonin metabolism in post-bariatric hypoglycemia.The Journal of clinical investigation · 2024Article
- Bariatric surgery and diabetes: Current challenges and perspectives.World journal of diabetes · 2024Review
- Cognition in patients with post-bariatric hypoglycemia.Obesity (Silver Spring, Md.) · 2024Article
- Postprandial hypoglycemia as a complication of bariatric and metabolic surgery: a comprehensive review of literature.Frontiers in surgery · 2024Review
- Strategies to Maintain the Remission of Diabetes Following Metabolic Surgery.Journal of metabolic and bariatric surgery · 2023Review
- Insulinoma Misdiagnosed as Post-bariatric Hypoglycemia: A Case Report and Review of the Literature.Cureus · 2023Article
- Glucose metabolism after bariatric surgery: implications for T2DM remission and hypoglycaemia.Nature reviews. Endocrinology · 2023Review
- Review
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Authors and funding
11 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundPostbariatric hypoglycemia (PBH) can be a devastating complication for which current therapies are often incompletely effective. More information is needed regarding frequency, incidence, and risk factors for PBH.
objectivesTo examine hypoglycemia symptoms following Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) and baseline and in-study risk factors.
settingMulticenter, at 10 US hospitals in 6 geographically diverse clinical centers.
methodsA prospective, longitudinal cohort study of adults undergoing RYGB or LAGB as part of clinical care between 2006 and 2009 were recruited and followed until January 31, 2015, with baseline and annual postoperative research assessments. We analyzed baseline prevalence and post-operative incidence and frequency of self-reported hypoglycemia symptoms as well as potential preoperative risk factors.
resultsIn all groups, postoperative prevalence of hypoglycemia symptoms was 38.5%. Symptom prevalence increased postoperatively from 2.8%-36.4% after RYGB in patients without preoperative diabetes (T2D), with similar patterns in prediabetes (4.9%-29.1%). Individuals with T2D had higher baseline hypoglycemia symptoms (28.9%), increasing after RYGB (57.9%). Hypoglycemia symptoms were lower after LAGB, with 39.1% reported hypoglycemia symptoms at only 1 postoperative visit with few (4.0%) having persistent symptoms at 6 or more annual visits. Timing of symptoms was not restricted to the postprandial state. Symptoms of severe hypoglycemia were reported in 2.6-3.6% after RYGB. The dominant risk factor for postoperative symptoms was preoperative symptoms; additionally, baseline selective serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitor use was also associated with increased risk in multivariable analysis. Weight loss and regain were not related to hypoglycemia symptom reporting.
conclusionHypoglycemia symptoms increase over time after RYGB, particularly in patients without diabetes. In a small percentage, symptoms can be persistent or severe and require hospitalization. Preoperative hypoglycemia symptoms and SSRI/SNRI use in RYGB patients without diabetes is associated with increased risk of symptoms.
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