title: Post-gastric-bypass hypoglycemia successfully treated with alpha-glucosidase inhibitor therapy.
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.
  
  
  CONCLUSIONS
  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.
authors: Department of Internal Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA.
authors: Shavon Y
authors: SY
authors: Frankhouser
authors: Aakif N
authors: AN
authors: Ahmad
authors: Gretchen A
authors: GA
authors: Perilli
authors: Benjamin J
authors: BJ
authors: Quintana
authors: Marc A
authors: MA
authors: Vengrove
mesh_terms: D000328:Adult; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D015390:Gastric Bypass; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D004791:Enzyme Inhibitors; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents