title: Increased risk of OGTT-induced hypoglycemia after gastric bypass in severely obese patients with normal glucose tolerance.
abstract: BACKGROUND
  Hypoglycemic episodes are described after bariatric surgery.
  
  
  OBJECTIVE
  To report the prevalence of hypoglycemia after a 75 g oral glucose load (OGTT) after Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (LAGB), and to identify predicting factors.
  
  
  METHODS
  Bariatric surgery referral center.
  
  
  METHODS
  Prospective cohort of 351 consecutive patients before and 12 months after bariatric surgery, on whom an OGTT was performed. The main outcome measure was postchallenge hypoglycemia (PCHy), defined as a 120 minute plasma glucose value<2.8 mmol/L (50.4 mg/dL).
  
  
  RESULTS
  Only patients with an RYGB presented with PCHy. It occurred in 23 patients or a prevalence of 10.4% after an RYGB. The OR was 25.5 (95% CI 3.4-191; P<.001) compared with before surgery. Patients with PCHy after surgery had a lower glycated hemoglobin (HbA1c), and a lower 2-hour postchallenge value before surgery. Before surgery, patients with normal glucose tolerance had an increased risk of PCHy after surgery (OR 8.6, 95% CI 2.0-37.6; P< .001).
  
  
  CONCLUSIONS
  The prevalence of OGTT-induced hypoglycemia is increased 25.5 times, 12 months after an RYGB. This is not observed after a gastric banding.
authors.affiliation: Inserm U859, Biotherapy Diabetes, Department of Nutrition, University of Lille, CHRU Lille, Lille, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Pigeyre
authors.affiliation: Cardiovascular and Metabolic Disease Department, CHU de Toulouse, Toulouse, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Vaurs
authors.affiliation: Inserm U859, Biotherapy Diabetes, Department of General and Endocrine Surgery, University of Lille, CHRU Lille, Lille, France.
authors.forename: Violeta
authors.initials: V
authors.lastname: Raverdy
authors.affiliation: Cardiovascular and Metabolic Disease Department, CHU de Toulouse, Toulouse, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Hanaire
authors.affiliation: Cardiovascular and Metabolic Disease Department, CHU de Toulouse, Toulouse, France; Inserm UMR 1027, Université Paul Sabatier, Université de Toulouse 3, Toulouse, France. Electronic address: Patrick.ritz@wanadoo.fr.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ritz
authors.affiliation: Inserm U859, Biotherapy Diabetes, Department of General and Endocrine Surgery, University of Lille, CHRU Lille, Lille, France.
authors.forename: François
authors.initials: F
authors.lastname: Pattou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015390:Gastric Bypass / Q000009:adverse effects*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D015431:Weight Loss; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Bariatric surgery; Blood glucose; Gastroplasty; Hypoglycemia