Incidence and risk factors of post-metabolic and bariatric surgery hypoglycemia: a systematic review
Authors' conclusion
The review highlights higher MBSH risk in younger women with significant weight loss after RYGB, and those with prior cholecystectomy or antidepressant use. Systematic summarization of MBSH criteria allowed us to identify the predictors for MBSH, which can aid in early diagnosis and treatment, reducing the need for prolonged monitoring.
Study context
- Population
- Patients after metabolic and bariatric surgery (RYGB, SG, gastric banding, duodenal switch, omega-loop gastric bypass, vertical banded gastroplasty); RCTs and analytical studies to August 202329 studies
- Comparison
- Self-report vs OGTT vs Mixed-meal tolerance test vs CGM
- Outcome
- Incidence and risk factors of post-metabolic and bariatric surgery hypoglycemia (MBSH)
- Follow-up
- 1 to 22 years
Pooled result
As reported in the abstract
Incidence of MBSH by diagnostic method
Self-report
2.6-66.4%
OGTT
6.6-61.8%
Mixed-meal tolerance test
29.4-78.6%
CGM
50-75%
Further pooled results
Risk factors and predictors of MBSH
- IGF-1 (OR)
- 1.06
- Fasting glicentin (AUC)
- 0.81
- HbA1c (AUC)
- 0.76
- Absolute weight reduction (AUC)
- 0.72
- Greater glucose fluctuations (OR)
- 1.98
- Higher-risk profile: mean age 49.8 years, 89.0% women, better glycemic control, RYGB, 86.5% of estimated weight loss
- Prior cholecystectomy or antidepressant therapy: particular caution
Original publication
Incidence and risk factors of post-metabolic and bariatric surgery hypoglycemia: a systematic review. Int J Obes (Lond). Published 24 October 2024. doi:10.
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