Postprandial hypoglycaemia after gastric bypass in type 2 diabetes: pathophysiological mechanisms and clinical implications
Main finding · SE 72Result — go to the resultMean group difference in tracer-derived glucose clearance AUC0-180 min +261 ml min-1 kg-1 × minAuthors' conclusion
Our results demonstrate that post-bypass PPHG occurs frequently in individuals with a history of type 2 diabetes, often without warning symptoms, and expose its complex pathogenetic mechanisms, revealing potential therapeutic targets.
Study context
- Population
- People with T2D treated with RYGB (14 women; median [IQR] age 53.5 [13.8] years, BMI 29.3 [6.3] kg/m², HbA1c 36.0 [6.2] mmol/mol)
- Participants
- 24 people
- Comparison
- PPHG vs no PPHG after RYGB
- PPHGn = 12
- Outcome
- PPHG on 300 min 75 g OGTT and its pathogenetic mechanisms
Methodological detailsdual-tracer, frequently sampled 300 min 75 g OGTT, mathematical modelling of glucose fluxes and beta cell function
- Dual-tracer, frequently sampled 300 min 75 g OGTT
- Mathematical modelling of glucose fluxes and beta cell function
Main finding
SE 72
Mean group difference in tracer-derived glucose clearance AUC0-180 min
+261 ml min-1 kg-1 × min
As reported in the abstract
- PPHG occurred, mostly without symptoms
- 12 (50%)
Observational data: associations, not effects.
Further findings
Counterregulatory responses
- PPHG participants had defective counterregulatory hormone responses, preventing increase in endogenous glucose production and symptoms/signs of sympathetic activation and neuroglycopenia
Free-living glycaemia and diet · 14 day CGM
- PPHG associated with more frequent and prolonged hypoglycaemia on CGM and altered dietary habits
Original publication
Postprandial hypoglycaemia after gastric bypass in type 2 diabetes: pathophysiological mechanisms and clinical implications. Diabetologia. Published 29 November 2024. doi:10.
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