title: Medical nutrition therapy for post-bariatric hypoglycemia: practical insights.
abstract: Hypoglycemia is increasingly recognized as a complication of bariatric surgery. Although medications are often required, medical nutrition therapy remains the key cornerstone for successful prevention of hypoglycemia in patients with post-bariatric hypoglycemia (PBH). We provide suggested approaches to the dietary management of PBH, incorporating data from both the medical literature and extensive clinical experience in an academic referral center for PBH. The overall goal of medical nutrition therapy for PBH is to reduce postprandial surges in glucose, which often trigger surges in insulin secretion and promote subsequent hypoglycemia. Thus, strategies focus on controlled portions of low glycemic index carbohydrates, avoidance of rapidly-absorbed carbohydrates, adjustment of timing of meals and snacks, and attention to personal and cultural barriers to implementation.
authors.affiliation: Hypoglycemia Clinic, Joslin Diabetes Center, Boston MA.
authors.forename: Emmy
authors.initials: E
authors.lastname: Suhl
authors.affiliation: Hypoglycemia Clinic, Joslin Diabetes Center, Boston MA.
authors.forename: Sue-Ellen
authors.initials: SE
authors.lastname: Anderson-Haynes
authors.affiliation: Hypoglycemia Clinic, Joslin Diabetes Center, Boston MA; Research Division, Joslin Diabetes Center, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mulla
authors.affiliation: Hypoglycemia Clinic, Joslin Diabetes Center, Boston MA; Research Division, Joslin Diabetes Center, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: mary.elizabeth.patti@joslin.harvard.edu.
authors.forename: Mary-Elizabeth
authors.initials: ME
authors.lastname: Patti
mesh_terms: D000428:Alcohol Drinking / Q000517:prevention & control; D050110:Bariatric Surgery / Q000009:adverse effects*; D002110:Caffeine / Q000008:administration & dosage; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D000072001:Diet, Healthy; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D005247:Feeding Behavior; D006801:Humans; D007003:Hypoglycemia / Q000178:diet therapy* / Q000517:prevention & control; D062407:Meals; D008903:Minerals / Q000008:administration & dosage; D044623:Nutrition Therapy / Q000379:methods; D010353:Patient Education as Topic; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000178:diet therapy; D062410:Snacks; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D000697:Central Nervous System Stimulants; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D008903:Minerals; D014815:Vitamins; D002110:Caffeine
keywords: Bariatric surgery; Hypoglycemia; Medical nutrition therapy