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Risk of post‐gastric bypass surgery hypoglycemia in nondiabetic individuals: A single center experience
Author(s) -
Lee Clare J.,
Wood G. Craig,
Lazo Mariana,
Brown Todd T.,
Clark Jeanne M.,
Still Christopher,
Benotti Peter
Publication year - 2016
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21479
Subject(s) - medicine , hypoglycemia , incidence (geometry) , single center , gastric bypass surgery , proportional hazards model , cumulative incidence , weight loss , gastric bypass , cohort , surgery , cohort study , obesity , insulin , optics , physics
Objective The epidemiology of post‐gastric bypass surgery hypoglycemia (PGBH) is incompletely understood. This study aimed to evaluate the risk of PGBH among nondiabetic patients and associated factors. Methods A cohort study of nondiabetic patients who underwent Roux‐en‐Y gastric bypass (RYGB) was conducted. PGBH was defined by any postoperative record of glucose < 60 mg/dL, diagnosis of hypoglycemia, or any medication use for treatment of PGBH. Kaplan‐Meier analysis was used to describe PGBH occurrence, log‐rank tests, and Cox regression to examine associated factors. Results Of the 1,206 eligible patients, 86% were female with mean age of 43.7 years, mean preoperative BMI of 48.7 kg/m 2 , and a mean follow‐up of 4.8 years. The cumulative incidence of hypoglycemia at 1 and 5 years post‐RYGB was 2.7% and 13.3%, respectively. Incidence of PGBH was identified in 158 patients and was associated with lower preoperative BMI ( P = 0.048), lower preoperative HbA1c ( P = 0.012), and higher 6‐month percent of excess body weight loss (%EWL) ( P = 0.001). A lower preoperative HbA1c (HR = 1.73, P = 0.0034) and higher 6‐month %EWL (HR = 1.96, P = 0.0074) remained independently correlated with increased risk for PGBH in multi‐regression analysis. Conclusions The 5‐year incidence of PGBH among nondiabetic individuals was 13.3% and was associated with a lower preoperative HbA1c and greater weight loss at 6 months following surgery.