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Endocr Pract. 2013 May-Jun;19(3):511-4. doi: 10.4158/EP12281.RA.

Post-gastric-bypass hypoglycemia successfully treated with alpha-glucosidase inhibitor therapy.

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1
Department of Internal Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA.

Abstract

OBJECTIVE:

To review the effectiveness of alpha-glucosidase inhibitor (AGI) therapy in the treatment of hypoglycemia after Roux-en-y gastric surgery.

METHODS:

Retrospective case review.

RESULTS:

Four patients who previously underwent Roux-en-y gastric bypass were evaluated because of severe symptomatic postprandial hypoglycemia that was unresponsive to a low-carbohydrate diet. Mixed-meal testing confirmed hyperinsulinemia. Other causes of hypoglycemia were ruled out by a combination of clinical examination, endocrine testing, and computed tomography imaging. Symptomatic hypoglycemia resolved in all 4 patients after AGI therapy was started. One patient could not tolerate long-term therapy because of a rash. The other 3 patients were followed for between 5 and 48 months and remained free of symptomatic postprandial hypoglycemia.

CONCLUSION:

AGI therapy is effective in the long-term treatment of post-Roux-en-y hypoglycemia in patients unresponsive to a low-carbohydrate diet. To our knowledge, this is the first report documenting the long-term usefulness of this therapy in a series of patients.

PMID:
23337151
DOI:
10.4158/EP12281.RA
[Indexed for MEDLINE]

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