POSTBARIATRIC HYPOGLYCEMIA: THE VIEW OF AN ENDOCRINOLOGIST
Abstract
The obesity epidemic has led to an increase in the number of bariatric surgeries performed as the most effective method of treating obesity and the expansion of indications for their implementation; in this regard, endocrinologists are increasingly faced with late complications, including post-bariatric hypoglycemia. Postbariatric hypoglycemia is a rare but severe disorder of carbohydrate metabolism that occurs months or years after surgery on the upper gastrointestinal tract. Postbariatric hypoglycemia can be accompanied by severe clinical symptoms and lead to a decrease in the quality of life and disability of patients. It is difficult to assess the prevalence of hypoglycemia after bariatric surgery due to the lack of clear diagnostic criteria, the often hidden clinical picture, and the lack of awareness of doctors and patients about this complication. Hypoglycemia in this case is postprandial hyperinsulinemic in nature. The mechanisms of development of this complication have recently been actively discussed, and the production of incretins and dysregulation of insulin secretion are the subject of constant research in this area. Understanding the mechanisms of development of this condition allows us to develop optimal diagnostic and treatment methods. This review will discuss the pathophysiology, basic principles of diagnosis and treatment methods for postbariatric hypoglycemia.
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