title: Diagnostic tools for post-gastric bypass hypoglycaemia.
abstract: In spite of its evident success, several late complications can occur after gastric bypass surgery. One of these is post-gastric bypass hypoglycaemia. No evidence-based guidelines exist in the literature on how to confirm the presence of this syndrome. This study aims to describe and compare the tests aimed at making a diagnosis of post-gastric bypass hypoglycaemia and to provide a diagnostic approach based upon the available evidence. A search was conducted in PubMed, Cochrane and Embase. A few questionnaires have been developed to measure the severity of symptoms in post-gastric bypass hypoglycaemia but none has been validated. The gold standard for provocation of a hypoglycaemic event is the oral glucose tolerance test or the liquid mixed meal tolerance test. Both show a high prevalence of hypoglycaemia in post-gastric bypass patients with and without hypoglycaemic complaints as well as in healthy volunteers. No uniformly established cut-off values for glucose concentrations are defined in the literature for the diagnosis of post-gastric bypass hypoglycaemia. For establishing an accurate diagnosis of post-gastric bypass hypoglycaemia, a validated questionnaire, in connection with the diagnostic performance of provocation tests, is the most important thing missing. Given these shortcomings, we provide recommendations based upon the current literature.
authors: Department of Bariatric and Metabolic Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors: M
authors: M
authors: Emous
authors: Department of Endocrinology, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors: F L
authors: FL
authors: Ubels
authors: Department of Bariatric and Metabolic Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.|Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: A P
authors: AP
authors: van Beek
mesh_terms: D004377:Dumping Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011183:Postoperative Complications / Q000097:blood*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D015431:Weight Loss
keywords: Diagnosis; gastric bypass; hypoglycaemia